Shuval Kerem, DiPietro Loretta, Skinner Celette Sugg, Barlow Carolyn E, Morrow Jay, Goldsteen Robert, Kohl Harold W
Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas, School of Public Health, Dallas and Austin, Texas, USA Harold C Simmons Cancer Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Department of Exercise Science, The George Washington University, School of Public Health and Health Services, Washington, DC, USA.
Br J Sports Med. 2014 Oct;48(19):1451-5. doi: 10.1136/bjsports-2012-091357. Epub 2012 Sep 13.
Accumulating evidence emphasises a relationship between prolonged sitting and increased risk for cardiometabolic disorders and premature death irrespective of the protective effects of physical activity. Primary care physicians have the potential to play a key role in modifying patients' sedentary behaviour alongside physical activity.
A pilot study examining sedentary behaviour and physical activity counselling in a primary care clinic. A total of 157 patients completed a detailed survey related to lifestyle counselling received from their primary care physician. We analysed these responses to describe counselling practices within the 5A framework, and to examine correlates (ie, patients' demographics, sedentary behaviour and physical activity and clinical variables) related to receiving counselling.
A total of 10% received general advice to decrease sitting time, in comparison with 53% receiving general physical activity counselling. None, however, received a written plan pertaining to sedentary behaviour whereas 14% received a written physical activity prescription. Only 2% were provided with specific strategies for sedentary behaviour change in comparison with 10% for physical activity change. Multivariable analysis revealed that patients who were obese were more likely to receive counselling to decrease sitting (OR=7.0; 95% CI 1.4 to 35.2). In comparison, higher odds for receiving physical activity counselling were associated with being younger, aged 40-59 years (OR=2.4; 95% CI 1.1 to 5.4); and being a non-smoker (OR=6.1; 95% CI 1.3 to 28.4).
This study is the first to assess sedentary behaviour counselling practices in primary care and such practices appear to be infrequent. Future research should attempt to establish a 'knowledge base' to inform development of sedentary behaviour interventions, which should be followed by testing feasibility, efficacy, and subsequent effectiveness of these programmes in a clinical setting.
越来越多的证据表明，无论体育活动是否具有保护作用，长时间坐着都与心血管代谢紊乱风险增加和过早死亡有关。初级保健医生在改变患者久坐行为以及体育活动方面有可能发挥关键作用。
一项在初级保健诊所研究久坐行为和体育活动咨询的试点研究。共有157名患者完成了一项与从其初级保健医生处获得的生活方式咨询相关的详细调查。我们分析了这些回答，以描述5A框架内的咨询做法，并检查与接受咨询相关的相关因素（即患者的人口统计学特征、久坐行为和体育活动以及临床变量）。
共有10%的人收到了减少久坐时间的一般建议，相比之下，53%的人收到了一般体育活动咨询。然而，没有人收到与久坐行为相关的书面计划，而14%的人收到了体育活动书面处方。只有2%的人得到了改变久坐行为的具体策略，相比之下，得到改变体育活动策略的人有10%。多变量分析显示，肥胖患者更有可能接受减少久坐的咨询（比值比=7.0；95%置信区间1.4至35.2）。相比之下，接受体育活动咨询的较高几率与年龄较轻（40-59岁）（比值比=2.4；95%置信区间1.1至5.4）以及不吸烟（比值比=6.1；95%置信区间1.3至28.4）有关。
本研究首次评估初级保健中久坐行为咨询做法，且此类做法似乎并不常见。未来的研究应尝试建立一个“知识库”，为久坐行为干预措施的制定提供信息，随后应在临床环境中测试这些方案的可行性、有效性及后续效果。
