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Predictors of adherence to a physical activity counseling intervention delivered by exercise physiologists: secondary analysis of the NewCOACH trial data

Authors Johnson NA, Ewald B, Plotnikoff RC, Stacey FG, Brown WJ, Jones M, Holliday EG, James EL

Received 14 August 2018

Accepted for publication 30 October 2018

Published 29 November 2018 Volume 2018:12 Pages 2537—2543


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Natalie A Johnson,1–4 Ben Ewald,1–4 Ronald C Plotnikoff,3 Fiona G Stacey,1–4 Wendy J Brown,5 Mark Jones,1,4 Elizabeth G Holliday,1,4 Erica L James1–4

1School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; 2Priority Research Centre in Health Behaviour, University of Newcastle, NSW, Australia; 3Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, NSW, Australia; 4Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; 5Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia

Background: General practitioners (GPs) cite time as a barrier to physical activity counseling. An alternative for time-poor GPs in Australia is the referral of insufficiently active patients to exercise physiologists (EPs). As data on the predictors of adherence to physical activity counseling interventions are limited, this study aimed to identify the sociodemographic, medical, health, and psychological characteristics of insufficiently active primary care patients who adhered to a physical activity counseling intervention delivered by EPs.
Methods: This secondary analysis of data from the NewCOACH randomized trial used logistic regression to identify predictors of adherence, defined as patient participation in at least four of the five physical activity counseling sessions. EPs provided information about the number of sessions, while other potential predictors were obtained from the self-administered baseline questionnaire and medical summary sheets provided by the GPs.
Results: Of the 132 patients referred to an EP, 102 (77%) were adherent: 91 (69%) and eleven (8.3%) participated in all, or all but one, of the sessions, respectively. Of the remainder, seven (5.3%) patients participated in three sessions, seven (5.3%) participated in two sessions, five (3.8%) participated in one session, and eleven (8.3%) did not participate in any session. The odds of being adherent were 5.84 (95% CI 1.46–23.4, P≤0.05) times higher among retired participants than in those who were not in paid employment. The odds of being adherent 1) increased as the positive outcome expectation score increased (OR 1.89, 95% CI 1.12–3.18, P≤0.05) and 2) decreased as the duration (days) between referral and the initial counseling session increased (OR 0.95, 95% CI 0.92–0.98, P<0.01).
Conclusion: More than three quarters of the patients participated in all, or all but one, of the sessions. Being retired, positive outcome expectations, and having a shorter wait between referral and the initial appointment predicted adherence.

Keywords: insufficiently active, adherence, predictors, primary care, exercise physiologist, patients

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