The Activity Counseling Trial (ACT)

Objectives:

To compare the effects of 2 physical activity counseling interventions with current recommended care and with each other in a primary care setting.

Background:

Physical activity is important for health, yet few studies have examined the effectiveness of physical activity patient counseling in primary care. Although the US adult averages 3 physician visits a year, physical activity counseling is not routinely provided except to high risk patients or those with a known disease.

Subjects:

Eligible subjects included patients of physicians, physician assistants or nurse practitioners of 11 primary care facilities affliated with 3 clinical centers (California, Texas and Tennessee). After three screening visits, a sample of 395 female and 479 male inactive primary care patients aged 35 to 75 years without clinical cardiovascular disease were randomized to 3 groups: advice (control), assistance and counseling. The advice group received physician advice based on national recommendations, the assistance group received the same advice and educational materials plus a 30-40 minute counseling session, and the counseling group received the same intervention as the assistance group plus telephone based counseling at selected intervals. The primary outcomes were cardiorespiratory fitness as measured by V02Max and self-reported physical activity.

Conclusions:

Two patient counseling interventions differing in type and number of contacts were equally effective in women in improving cardiorespiratory fitness over 2 years compared with recommended care. In men, neither of the 2 counseling interventions was more effective than recommended care (JAMA 2001; 286(6):677-687).