Intervention To Improve Primary Care Practices’ Fitness Culture Did Not Translate Into Improvements In Physical Activity And Healthy Eating
Evaluating the effect of the American Academy of Family Physician’s Americans in Motion – Healthy Interventions public health initiative to promote physical activity, healthy eating, and emotional well-being as part of routine patient care, researchers found impressive before-after improvements in patient outcomes but no differences between two different implementation approaches.
The authors assessed the outcomes of 610 enrolled patients at 24 family medicine practices randomized to either an enhanced practice (asked to use AIM-HI tools to help office staff make personal changes and create a healthy practice environment) or a traditional practice (trained and asked to use the tools directly with patients). They hypothesized that practices which used the AIM-HI tools as a group to improve physician and office staff lifestyle behaviors and actively advertised their commitment to AIM-HI principles to their patients would be more successful in improving patient-level outcomes; however, they found no significant differences in the patient-outcomes between the two practice groups.
Regardless of practice group, 16 percent of patients who completed a 10-month visit (378 patients) and 10 percent of all patients enrolled lost 5 percent or more of their body weight. Moreover, of the patients who completed a 10-month visit, 17 percent had a 2-point or greater increase in their fitness level, and 29 percent lost 5 percent or more of their body weight and/or increased their fitness level by 2 or more points.
The authors posit several reasons for the lack of a between-group difference, including study design, patient selection, the nonprescriptive approach to AIM-HI, and already established physician workplace wellness activities that motivated the clinicians to intervene with patients.
Effectiveness of 2 Methods of Implementing the Americans in Motion: Healthy Interventions (AIM-HI) Approach to Promoting Physical Activity, Healthy Eating, and Emotional Well-being
By Wilson D. Pace, MD, et al
University of Colorado, Aurora
News From The Annals Of Family Medicine: July/August 2013