Not even computerized telephone pep talks appear to do the trick, a new study reports.
With idleness recognized as a risk factor for chronic ills such as coronary artery disease and high blood pressure, researchers are constantly seeking ways to get people off their butts and into their sneakers, says Bernadine M. Pinto, a psychologist at Brown Medical School/Miriam Hospital in Rhode Island.
Seventy-five percent of Americans don't get their recommended daily workout, which is 30 minutes of moderately intense exercise, she says.
So, Pinto and her colleagues designed a computer-based telephone system they hoped would surmount common roadblocks to fitness, and then tested it on 298 adults.
"Like telephone counseling offered by human counselors, we expected [the system] would overcome problems with scheduling and attending face-to-face meetings," Pinto says. "Unlike human counselors, [the system] would be accessible at any time and less likely to be perceived as judgmental."
The researchers gathered their sample group from the patient files of a Boston medical center and sent out letters explaining their objective. From those who expressed interest in the program, the researchers randomly selected people who were sedentary and ate lots of high fat and processed foods.
The participants, mostly female (72 percent) and 46 years old on average, were given a telephone number to call once a week.
When they did, half of them heard a computerized voice that asked them questions about their physical activity for the past week, and encouraged them to set new goals for the next seven days. The message also advised them what activities they could engage in that would qualify as moderate workouts.
The other half of the sample group received pep talks to improve their eating habits, but the computerized voice never mentioned exercise.
Depending on people's responses -- punched in on their telephone keypads -- calls lasted between five and 10 minutes.
The researchers then sent the patients and their physicians computer-generated monthly reports documenting exercise levels.
At first, the results looked promising. After three months, the researchers found that when automated counselors prompted the participants to exercise, they were more likely than the comparison group to do so. In fact, 26 percent of the first group was working out 30 minutes a day, compared to 20 percent of the second.
However, by the six-month mark, those receiving exhortations to exercise had pretty much unlaced their sneakers and resumed their idle ways. There was no longer any significant difference in exercise between the two groups.
"Unfortunately, the results weren't maintained so we have to think about what we could improve next time around to make certain people continue to use the system," says Pinto. "The issue with exercise is not only to get people to become active, but to stay active."
She believes one drawback was the researchers placed the onus of initiating the phone calls on the participants. In addition, some people said they'd have preferred to talk to a human being, while others said they would have liked someone to phone and remind them to make the weekly call.
Results of the study appear in the August issue of the American Journal of Preventive Medicine.
The researchers had greater success with the comparison group, whose diets improved and stayed that way for the length of the six-month trial. Those results formed the basis of a separate study reported in the March/April 2001 issue of the American Journal of Health Promotion.
Dr. Robert Silverstein, a cardiologist and director of the Preventive Medicine Center in Connecticut, says that despite the new study's disappointing outcome, finding ways to boost America's fitness levels should be an ongoing effort.
"Anything you can do to get people moving and eating healthily has merit. The more reminders, the more stimuli you can give people to exercise, to lose weight, to keep a positive attitude, the better off you are," he says.
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