Institute of Social and Preventive Medicine, University of Zürich, Zürich, Switzerland.
Swiss Med Wkly. 2009 Nov 14;139(45-46):665-71. doi: 10.4414/smw.2009.12680.
Given the demographic development, healthy aging becomes more and more relevant. However, physical activity as an important health resource lacks dissemination in persons of older age in Switzerland. Thus, the present study aimed to develop and evaluate a feasible approach for physical activity promotion in the promising primary care setting.
An expert panel developed two procedures for physical activity counselling in the primary care setting. The first complete procedure consisted of a written assessment and personal counselling by physicians. It was evaluated by focus groups with primary care physicians. The second modified procedure consisted of mailings to inactive patients selected by physicians. It was evaluated by a written questionnaire sent to participants.
The study demonstrated that physical activity promotion through primary care has a high potential. However, core issues such as dealing with time pressure on physicians, applying screening instruments on a broad basis beyond high risk patients, expanding physicians' roles towards primary prevention as well as providing intervention materials actually comprehensible to patients need to be well considered.
To facilitate large scale implementation of physical activity promotion, a range of flexible procedures should be provided so the physician can select and adapt them to his needs and desired role in health promotion. Further, physical activity promotion should be integrated into multidimensional health promotion to meet the diverse health needs of patients. The presented multi-stakeholder approach is generally recommended for future development of health promotion interventions.
鉴于人口结构的发展，健康老龄化变得越来越重要。然而，作为一项重要的健康资源，身体活动在瑞士的老年人群体中缺乏传播。因此，本研究旨在为初级保健环境中的身体活动促进制定并评估一种可行的方法。
一个专家小组为初级保健环境中的身体活动咨询制定了两个程序。第一个完整的程序包括医生的书面评估和个人咨询。它通过与初级保健医生的焦点小组进行了评估。第二个修改后的程序包括向医生选择的不活跃患者发送邮件。它通过向参与者发送书面问卷进行了评估。
研究表明，通过初级保健促进身体活动具有很大的潜力。然而，需要充分考虑一些核心问题，例如应对医生的时间压力，在高风险患者之外广泛应用筛选工具，扩大医生在初级预防方面的角色，以及提供实际上能被患者理解的干预材料。
为了促进身体活动促进的大规模实施，应提供一系列灵活的程序，以便医生可以根据自己的需求和在健康促进方面的期望角色选择和调整这些程序。此外，身体活动促进应纳入多维健康促进，以满足患者多样化的健康需求。所提出的多利益相关者方法通常被推荐用于未来健康促进干预措施的发展。
