Promoting public health by Physical activity on Prescription, with focus on organized exercise

Abstract: Background: Insufficient physical activity is a public health problem. Nordic healthcare professionals use physical activity on prescription (PaP) to increase physical activity. Purpose: This study aimed to evaluate the effectiveness of PaP that includes organized exercise. Method: Prospective data was obtained from four Swedish counties during fall 2009 and spring 2010. The study population comprised 98 patients whose healthcare professional prescribed PaP to prevent or treat disease. Questionnaires administered at baseline, three and six months after initiating PaP evaluated self-reported physical activity levels, adherence, factors influencing adherence, and experience of PaP. Results: Although the majority of patients receiving PaP including organized exercise are middle-age women, there are a wide distribution regarding e.g., age, socioeconomic status and reason of receiving PaP. Most participants received initial support from healthcare providers and activity organizers, and most were satisfied with the support they got. Approximately 70% participated in several activities at all measuring points. Although PaP including organized exercise increased activity levels only marginally, sedentary behavior decreased significantly. Six months after initiating PaP including organized exercise, 68% adhered to the prescribed physical activity level. Most participants deemed PaP including organized exercise a good method for becoming physically active. However, there is a need for regularly and longer support. Importantly, individualized instruction, adjusted exercise regimens, and support from other participants provide positive reinforcement. On the other hand, PaP with organized exercise imposes additional costs and decreases flexibility including both time commitment and scheduling constraints. Conclusion: Adherence levels to PaP with organized exercise are similar to those achieved by other chronic disease treatments. PaP including organized exercise can decrease sedentary behavior, an important factor in promoting public health in the Nordic countries.