Fox K, Biddle S, Edmunds L, Bowler I, Killoran A
School of Education, University of Exeter.
Br J Gen Pract. 1997 Jun;47(419):367-9.
There is increasing research supporting the argument for a beneficial link between physical activity and health maintenance and, in the past five years, this has led to a growth in physical activity promotion schemes involving primary health care.
To document and critically examine the extent and nature of physical activity promotion in general practice in England.
A postal survey to all family health services authorities and primary care facilitators was conducted to identify existing and planned activity promotion schemes involving primary health care. Telephone interviews with leaders from 50 selected schemes and further detailed case studies of 11 schemes provided descriptive information of the nature of physical activity promotion.
The initial phase revealed 157 existing schemes and a further 35 planned schemes. Two basic models of physical activity promotion were identified that were distinguishable by the primary location of the management of the patient. Practice-managed interventions (32%) involve on-site counselling to change the behaviour of patients. Leisure centre-managed projects (68%), sometimes termed 'exercise by prescription' or 'general practitioner referral for exercise' schemes, involve the identification of suitable patients and their referral to 10- to 12-week-long leisure centre based exercise induction courses. The projects in the planning stage were all of the latter type, indicating this as the favoured model. Although such schemes were generally successful in attracting patients, in all cases they involved less than 1% of the patient base from which they were drawn.
There is evidence of successful recruitment, increased short-term physical activity and fitness, and improvements in the well-being of patients. However, schemes are inadequately resourced for rigorous long-term evaluation; therefore, conclusions regarding the cost-effectiveness of the two models are not possible.
越来越多的研究支持体育活动与健康维持之间存在有益联系的观点，在过去五年中，这导致了涉及初级卫生保健的体育活动促进计划有所增加。
记录并批判性地审视英格兰全科医疗中体育活动促进的程度和性质。
对所有家庭健康服务机构和初级保健促进者进行了邮政调查，以确定现有的和计划中的涉及初级卫生保健的活动促进计划。对50个选定计划的负责人进行了电话访谈，并对11个计划进行了更详细的案例研究，提供了体育活动促进性质的描述性信息。
初始阶段发现了157个现有计划和另外35个计划。确定了两种基本的体育活动促进模式，它们可根据患者管理的主要地点来区分。由诊所管理的干预措施（32%）包括现场咨询，以改变患者的行为。由休闲中心管理的项目（68%），有时被称为“处方运动”或“全科医生转诊运动”计划，包括识别合适的患者并将他们转诊到基于休闲中心的为期10至12周的运动入门课程。处于规划阶段的项目都是后一种类型，表明这是更受欢迎的模式。尽管这些计划通常成功吸引了患者，但在所有情况下，参与计划的患者不到其来源患者群体的1%。
有证据表明招募成功，短期体育活动和身体素质增加，患者的幸福感得到改善。然而，这些计划的资源不足以进行严格的长期评估；因此，无法得出关于两种模式成本效益的结论。
