Physician counseling of older adults about physical activity: the importance of context.

PURPOSE: Physicians are encouraged to discuss physical activity with their older adult patients. Studies of physician-initiated counseling have yielded inconsistent results, perhaps because older adults' perceptions and concerns about such counseling have not been addressed. The objective of the present work was therefore to explore such perceptions and their implications.
DESIGN: Qualitative study, using a grounded theory approach. Data were collected using both focus groups and semistructured interviews.
SETTING: Data were collected in several settings, including a fitness center and physicians' offices.
SUBJECTS: In a first sample, 56 adults aged 65 and older participated in one of six focus group sessions examining physical activity and exercise. Subsequently, 16 older adults participated in one of two focus groups comprising a second, validation sample. Individual semistructured interviews were conducted with a sample of five physicians.
METHODS: Data collection and analysis took place concurrently. Transcripts were analyzed using the constant comparative method. Recruitment, data collection, and analysis were informed by grounded theory.
RESULTS: Inactive older adults experiencing a health problem were more receptive than their healthy counterparts to receiving physical activity counseling from their physicians. Those who were receptive appeared to find such an intervention useful in leading to behavior change.
CONCLUSION: This study suggests that physicians' efforts in physical activity counseling may have the best impact when provided in the context of a health problem.