The delivery of effective interventions to assist patients to improve their physical activity and dietary behaviors is a challenge in the busy primary care setting. Eakin and coworkers concluded a trial with health care practices randomized to telephone counseling intervention or usual care. Four-hundred thirty-four adult patients with type 2 diabetes or hypertension (mean age=58.2); 61% female; and mean BMI=31.1 from a disadvantaged community were recruited from ten primary care practices. The intervention consisted of twelve-month telephone counseling. Physical activity and dietary intake were assessed by self-report at baseline, 4, and 12 months. At 12 months, patients in both groups increased moderate-to-vigorous physical activity by a mean of 78 minutes per week (SE=10). Significant intervention effects (telephone counseling minus usual care) were observed for: (a) calories from total fat (decrease of 1.17%; p<0.007); (b) energy from saturated fat (decrease of 0.97%; p<0.007); (c) vegetable intake (increase of 0.71 servings; p<0.039); (d) fruit intake (increase of 0.30 servings; p<0.001); (e) and grams of fiber (increase of 2.23 g; p<0.001).

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The study targeted a challenging primary care patient sample and, using a telephone-delivered intervention, demonstrated modest improvements in diet and in physical activity. Results suggested that telephone counseling is a feasible means of delivering lifestyle intervention to primary care patients with chronic conditions--patients whose need for ongoing support for lifestyle change is often beyond the capacity of primary healthcare practitioners.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Telephone and computer texting are increasingly being used to teach patients how to manage physical conditions. If your health care provider offers you the opportunity to participate in a similar program for your condition, please volunteer for the experience. It will not only teach you skills you can perform to manage your illness, but also provide support from a health care team.

E Eakin et al. Telephone Counseling for Physical Activity and Diet in Primary Care Patients. American Journal of Preventive Medicine, December 4, 2008.