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Within the busy clinic visit and multiple preventive guidelines to follow, the rate of physician referral for physical activity (PA) is disappointing. This study used an interrupted time-series design to determine the effect of a simple stimulus control strategy to increase physician referrals for PA when compared to standard care before and after exposure to the stimulus control intervention. The number of referrals (N = 218 total) per week was significantly higher during weeks when the stimulus control intervention was used (p < .01). Approximately 77% of participants referred during standard care weeks initiated a PA program while 67% of those referred during stimulus control weeks initiated PA. These rate differences were significant (p < .05). Nonetheless, the number of individuals who initiated PA was greater during stimulus control weeks than during usual care weeks (p < .05; 9.8 vs. 5.6), due to the larger total volume of referrals. We concluded that stimulus control interventions targeting physician referrals are a practical method for enhancing participation in PA programs.
The authors are with Kaiser Permanente Colorado
Clinical Research Unit
Aurora Centrepoint Clinic, Denver, CO 80237-8066.