Though the health hazards of inactivity are generally known, few Americans meet national recommendations for physical activity and rural adults, in particular, are very inactive. CHOICE (Choosing Healthy Options: I Can Exercise) by Phone is an intervention to increase choice-based lifestyle physical activity in underactive adults living in rural communities. The long-term objective of CHOICE by Phone is to develop an efficient, cost-effective program to support increased physical activity, and other health behavior changes, in rural adults across a wide region, using telephone counseling originating from a single location. CHOICE by Phone is innovative because it will be the first physical activity study to rely on counseling sessions conducted solely on the telephone without an initial face-to-face session. Thus, CHOICE by Phone is a practical approach to the challenge of providing expert health behavior counseling to residents of small rural communities where local health clinicians may not have the expertise or time to provide lengthy individualized counseling.
The specific aims of the proposed study are to: (1) obtain preliminary evidence for CHOICE by Phone's effects in increasing physical activity in underactive rural adults, and (2) refine implementation and evaluation procedures of CHOICE by Phone, in preparation for a future trial. This randomized, controlled pilot study will enroll 76 rural adults, aged 25 and older, who are currently inactive, but who express an interest in becoming more active. The sample will be drawn from patients at four primary care clinics in rural communities in Oregon. One clinician at each clinic (physicians and nurse practitioners) will be trained in 5-minute brief motivational advice to encourage physical activity and recruit potential participants to this study. Participants will be randomized to one of two groups. CHOICE by Phone group members will receive 6 telephone calls over a 6-month period during which the Physical Activity Counselor will use motivational interviewing strategies to help participants choose their preferred type of activities, set their own goals, and resolve issues that arise. Control group members will receive the same number of telephone calls, but the content will be brief conversation without the motivation strategies that are the core of the CHOICE by Phone intervention. Measurement surveys will be mailed to participants with pre-paid return envelopes. The evidence for CHOICE by Phone's effects on increasing physical activity will be determined by a test of the group by time interaction using a repeated measures analysis of variance.
| Bennett, Jill A; Young, Heather M; Nail, Lillian M et al. (2008) A telephone-only motivational intervention to increase physical activity in rural adults: a randomized controlled trial. Nurs Res 57:24-32 |
