Why target sedentary adults in primary health care? Baseline results from the Waikato Heart, Health, and Activity Study.

Abstract

The question of whether the public health issue of physical inactivity should be addressed in primary health care is a controversial matter. Baseline cross-sectional analysis of a physician-based physical activity intervention trial involving sedentary adults was undertaken within 42 rural and urban family practices in New Zealand to examine self-reported levels of physical activity and cardiovascular risk factors. A self-administered single question about physical activity was used to screen 40- to 79-year-old patients from waiting rooms for physical inactivity. The positive predictive value of the screening question was 81%. Participation rates for the study were high, including 74% of family physicians (n = 117) in the region. Eighty-eight percent of consecutive patients in the age group agreed to be screened and 46% were identified as sedentary. Of those eligible, 66% (n = 878) agreed to participate in a study involving a lifestyle intervention from their family physician. Blood pressure and BMI were significantly greater than that in the general population. There were high rates of hypertension (52%), diabetes (10.5%), obesity (43%), previous cardiovascular disease (19%), and risk factors for cardiovascular disease (93%). Decreasing total energy expenditure was associated with increasing cardiovascular risk (P = 0.001). Sedentary adults in primary care represent a high cardiovascular risk population. Screening for inactivity in primary care is effective and efficient. Two-thirds of sedentary adults agreed to receive a lifestyle intervention from their family physician.