Report: Clinicians should routinely counsel patients on physical activity

A new study led by American Cancer Society researchers in collaboration with leading experts concludes that physical activity should be routinely assessed during the doctor-patient encounter, and that clinicians should design in collaboration with their patients a detailed physical activity plan with goals that should be set and monitored. The study uses concepts from public health and behavioral economics to provide practical advice to clinicians on effective counseling to patients.

The study appears early online in CA: A Cancer Journal for Clinicians. Below are highlights of the study:

• Despite abundant evidence linking physical inactivity to increased risk for numerous chronic conditions, such as some types of cancer, heart disease, , type 2 diabetes, stroke, and even depression, physical inactivity is prevalent in modern society.
• In the United States, 51% of adults report not meeting aerobic physical activity guidelines, while objective measurement using accelerometers finds about 96.5% of adults ages 20 to 59 years do not meet those guidelines.
• The study, led by Kerem Shuval, PhD, and Tammy Leonard, PhD reports that because physicians' advice is respected and physician-patient encounters are frequent, these meetings can be used to provide consistent and comprehensive physical activity counseling, which may be an important vehicle for reducing the risk of chronic diseases and premature death.
• Physical activity should be routinely assessed at the clinic visit, a detailed physical activity plan should be jointly designed with the patient, and goals should be set and monitored.
• Specific strategies should be provided to patients to overcome impediments to activity. Both conscious and unconscious factors affect patients' behaviors and should be taken into account by the clinician and patient.
• Although the primary care setting is an important avenue to pursue physical activity promotion, it is not the only one. Policies aimed at changing the environment to one that is conducive to an active lifestyle are necessary to encourage sustainable changes.

"Physical activity is a modifiable behavior that has the potential to prevent numerous diseases, however, so many of us are not sufficiently active. Both conscious and unconscious factors are at play that influence our behavior." said Dr. Shuval. "It's difficult to choose activities we 'should' do over those we 'want' to do. Clinicians can help play a role in creating strategies, like encouraging the use of pre-commitment contracts, which impose constraints on our 'future selves' to act in a way the will benefit us in the long run."