Ongoing physical activity advice by humans versus computers: the Community Health Advice by Telephone (CHAT) trial.

PURPOSE Given the prevalence of physical inactivity among American adults, convenient, low-cost interventions are strongly indicated. This study determined the 6- and 12-month effectiveness of telephone interventions delivered by health educators or by an automated computer system in promoting physical activity. DESIGN Initially inactive men and women age 55 years and older (N = 218) in stable health participated. Participants were randomly assigned to human advice, automated advice, or health education control. MEASURES The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. Physical activity differences by experimental arm were verified on a random subsample via accelerometry. RESULTS Using intention-to-treat analysis, at 6 months, participants in both interventions, although not differing from one another, showed significant improvements in weekly physical activity compared with controls. These differences were generally maintained at 12 months, with both intervention arms remaining above the target of 150 min per week of moderate to vigorous physical activity on average. CONCLUSION Automated telephone-linked delivery systems represent an effective alternative for delivering physical activity advice to inactive older adults.

[1]  W. Rejeski,et al.  Physical activity and quality of life in older adults. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[2]  W L Haskell,et al.  Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[3]  B. Marcus,et al.  The transtheoretical model: applications to exercise behavior. , 1994, Medicine and science in sports and exercise.

[4]  A. Manley.  Physical Activity And Health: A Report Of The Surgeon General , 2004 .

[5]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[6]  B. Efron.  Forcing a sequential experiment to be balanced , 1971 .

[7]  A. Stewart,et al.  CHAMPS physical activity questionnaire for older adults: outcomes for interventions. , 2001, Medicine and science in sports and exercise.

[8]  J. Sallis,et al.  Reliability of interviewers using the Seven-Day Physical Activity Recall. , 1990, Research quarterly for exercise and sport.

[9]  James F. Sallis,et al.  Correlates of satisfaction with body function and body appearance in middle- and older aged adults: The activity counseling trial (ACT) , 2000 .

[10]  A. King,et al.  Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  M. V. Vander Weg,et al.  Evaluation of the 7-day physical activity recall in urban and rural men. , 2004, Medicine and science in sports and exercise.

[12]  A. Stewart,et al.  An evaluation of three self-report physical activity instruments for older adults. , 2001, Medicine and science in sports and exercise.

[13]  C. Caspersen,et al.  A survey for assessing physical activity among older adults. , 1993, Medicine and science in sports and exercise.

[14]  B E Ainsworth,et al.  Compendium of physical activities: an update of activity codes and MET intensities. , 2000, Medicine and science in sports and exercise.

[15]  Patricia Dolan Mullen,et al.  Increasing Physical Activity A Report on Recommendations of the Task Force on Community Preventive Services , 2008 .

[16]  Cynthia M. Castro,et al.  Telephone-Assisted Counseling for Physical Activity , 2002, Exercise and sport sciences reviews.

[17]  C. Tudor-Locke,et al.  Measuring accumulated health-related benefits of exercise participation for older adults: the Vitality Plus Scale. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[18]  Robert Friedman,et al.  Harnessing motivational forces in the promotion of physical activity: the Community Health Advice by Telephone (CHAT) project. , 2002, Health education research.

[19]  S. Blair,et al.  Physical activity behavior change: issues in adoption and maintenance. , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[20]  Jane S. Webster,et al.  Rational and social theories as complementary explanations of communication media choices: two polic , 1995 .

[21]  J. Sallis,et al.  Reliability and validity of self-reported physical activity in Latinos. , 1992, International journal of epidemiology.

[22]  Helena Chmura Kraemer,et al.  How Many Subjects? Statistical Power Analysis in Research , 1987 .

[23]  Barbara E. Ainsworth,et al.  Accuracy of five electronic pedometers for measuring distance walked. , 1996, Medicine and science in sports and exercise.

[24]  B. Marcus,et al.  Efficacy of an individualized, motivationally-tailored physical activity intervention , 1998, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[25]  J. Sallis,et al.  Physical activity assessment methodology in the Five-City Project. , 1985, American journal of epidemiology.

[26]  H. Kraemer,et al.  Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making. , 1997, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[27]  A. King,et al.  Physical Activity Preferences of Middle-Aged and Older Adults: A Community Analysis , 1999 .

[28]  James F. Sallis,et al.  Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of U.S. middle-aged and older-aged women. , 2000 .

[29]  Carlo C. DiClemente,et al.  The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy , 1994 .

[30]  A. Bandura.  Social cognitive theory: an agentic perspective. , 1999, Annual review of psychology.

[31]  Timothy M. Morgan,et al.  Effects of physical activity counseling in primary care: the Activity Counseling Trial: a randomized controlled trial. , 2001, JAMA.

[32]  Robert Friedman,et al.  Effects of a computer-based, telephone-counseling system on physical activity. , 2002, American journal of preventive medicine.

[33]  T. Kamarck,et al.  A global measure of perceived stress. , 1983, Journal of health and social behavior.

[34]  C R Nigg,et al.  Interactive communication strategies: implications for population-based physical-activity promotion. , 2000, American journal of preventive medicine.

[35]  L. Kuller,et al.  Lifestyle intervention can prevent weight gain during menopause: Results from a 5-year randomized clinical trial , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[36]  P. Corso,et al.  The effectiveness of interventions to increase physical activity. A systematic review. , 2002, American journal of preventive medicine.

[37]  K. Vranizan,et al.  Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. , 1985, American journal of epidemiology.

[38]  T Heeren,et al.  Older women and physical activity: using the telephone to walk. , 1997, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[39]  A. Stewart,et al.  The California active aging community grant program: Translating science Into practice to promote physical activity in older adults , 2005, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.