September 7, 2003
Phone: (504) 865-5714
Chances are you don't get enough exercise. "Well over half of us are not getting as much physical activity as we need, and close to a quarter of us are not really getting any," said Rebecca Meriwether. "Yet our current evidence suggests that physical activity is at least as important as healthy eating and is more important than weight when it comes to staying healthy."
Meriwether, an assistant professor of family and community medicine, is using the support of the Robert Woods Johnson Foundation's Generalist Physician Faculty Scholars Program to focus on this basic and important issue. One of the ways she's doing that is by working with physicians to help them do a better job of assessing and promoting physical activity with their patients.
She's wrapping up a study that tests the accuracy of a brief questionnaire she has developed for physicians to use to better understand the level of physical activity their patients are getting and would consider doing. It's being compared to results from an established questionnaire used to measure act-ivity and the objective results from a pedometer and accelerometer.
Now she's set to begin an intervention study to see if patients can be motivated to be more active using an approach she's developed and uses with her own patients.
"For a variety of reasons, physicians have not been counseling people as much as we would like," Meriwether said. "But I find in my practice that when I talk to people about physical activity, they're very receptive, especially when I tell them they can get what they need in 10-minute increments."
The consensus used to be that people needed 20 minutes of vigorous activity three times a week to benefit from exercise.
But these days, the Surgeon General, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend 30 minutes of moderate activity--like walking fastfive or more days a week. Many people are relieved to hear that less strenuous activity counts, even if they have to spend a little more time getting it.
"I tell my patients to start with what they're already doing and push themselves just a little bit," Meriwether said. A fast 30-minute walk around the loop in Audubon Park will meet the daily recommendation. And things like gardening, vacuuming, sweeping, mopping, mowing the lawn and carrying laundry baskets around all countbut the irony is that we've engineered much of the physical activity out of our lives, then added going to the gym to our list of chores.
"The tools we developed give people guidance about both the type of activity and the way it would feel," she said. "We have a list of activities that for most people would be in the moderate or vigorous category, to try to give them an idea of what would count. We've also developed brochures that help people make plans for how to get around their roadblocks and get the activity they need to look and feel good and improve their health."
The counseling study will be done with family physicians throughout New Orleans. "We'll be testing the effect of delivering a family-centered counseling message. The target of the intervention is the individual within the context of the family," Meriwether said.
She's been recruiting primary care physicians to be part of a practice- based research network that will participate in this study and others. The network, a collaboration between Tulane University and Ochsner Clinic Foundation, includes 30 doctors in 20 practices.
"A lot of the research we rely on in clinical practice is done in referral centers by specialists. But the patients we see in community-based family practices are different from the patients specialists see, so we also need to do research in our offices so that we can better understand how to care for the patients we see every day," she said.
Meriwether plans to continue working on helping patients stay healthy and will work with participating physicians to answer research questions that arise as they see patients.
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org