Systematic review and meta-analysis of primary care-based physical activity interventions among older adults

Abstract

Background. Most healthcare providers agree that increasing physical activity (PA) in older adults is beneficial but providing effective interventions can be difficult. The purpose of this research is to determine the effectiveness of primary care interventions to increase PA levels in older adults and to analyze which interventions are most effective. Methods. A comprehensive search was conducted to find studies that tested interventions delivered in primary care to improve levels of physical activity in adults [greater than] 65 or with a mean age of [greater than] 70. Standardized mean difference effect size was calculated related to changes in physical activity levels. Moderator analysis was performed to explore the relationship between participant characteristics, interventions, and interventionists, and effect size. Results. Overall mean effect size 0.27 (95% CI 0.15-0.39, p [equals] 0.000) was calculated for 25 two- group comparisons involving 4,685 total participants. Mean age of participants was 75.08. Most involved counseling by the primary provider or different healthcare providers. Counseling was provided in person or via the phone. The use of physical or occupational therapists, number of counseling sessions and an exercise referral were significant moderators. There was little evidence to support counseling over exercise referrals. The use of theory and use of a pedometer did not modify the effect size. Conclusion. PA interventions delivered in primary care are effective. PA interventions can be effectively delivered by other healthcare providers working with the primary provider. Many different behavior change strategies may be used to promote PA. More research is needed to explore interventions to promote long term changes in PA levels as well as interventions for adults [greater than] 80 years old and older adults that are members of minority groups.