Cara Dhaliwall, Erinmacpherson ., Julie Richardson


Objective: Telephone calls can potentially be an accessible and cost-effective modality for delivering physical activity (PA) interventions to primary care patients. This review aims to evaluate the effectiveness of telephone counseling to increase PA levels in persons with type 2 diabetes (T2D) or hypertension.

Methods: A systematic search (to May 2014) was conducted on the following databases, CINHAL, EMBASE, MEDLINE, Pub Med, and Psych INFO. Articles were included if they contained a control group, included participants with T2D or hypertension, implemented predominately a PA intervention, included PA as a primary outcome measure, and used telephone calls as a predominant delivery method for the intervention.

Results: Thirteen articles that reported on eight studies were included in the final review. All eight studies assessed PA levels at the end of the intervention (post-intervention), and five studies assessed PA levels at follow-up. Post-intervention, 5/8 studies produced a significant effect on PA outcomes (with increases in PA favoring the experimental group). Large effect sizes (Cohen’s d>0.8) were calculated for three studies, and a medium (Cohen’s d: 0.5-0.79) and small effect sizes (Cohen’s d: 0.2-0.49) were calculated for one study. At follow-up, 3/5 studies produced a significant effect on PA outcomes. One study reported a large effect size and two studies reported a small effect size.

Conclusions: Telephone calls show promise for delivering PA interventions for persons with T2D. No conclusions can be made regarding the effectiveness of telephone calls for persons with hypertension (only one study reported the number of patients with hypertension).

Keywords: Physical activity, Exercise, Telephone, Type 2 Diabetes, Hypertension.

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World Health Organization. Media Center, Diabetes. Fact sheet #312; 2013. Available from: URL: http://www.who.int/mediacentre/factsheets/fs312/en/. [Last accessed on 25 Jul 2014]

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217-23.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes estimates for the year 2000 and projections for 2030. Diabetes care 2004;27:1047-53.

Chung HH, Won KC. Prevalence, Awareness, and control of hypertension among diabetic koreans. Diabetes Metab J 2011;35:337-9.

Engström G, Hedblad B, Janzon L. Hypertensive men who exercise regularly have lower rate of cardiovascular mortality. J Hypertens 1999;17:737-42.

Hackam DG, Quinn RR, Ravani P, Rabi DM, Dasgupta K, Daskalopoulou SS, et al. The 2013 canadian hypertension education program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol 2013;29:528-42.

Hu G, Jousilahti P, Barengo NC, Qiao Q, Lakka TA, Tuomilehto J. Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes. Diabetes Care 2005;28:799-805.

Sigal RJ, Armstrong MJ, Colby P, Kenny GP, Plotnikoff RC, Reichert SM, et al. Physical activity and diabetes. Canadian journal of diabetes. 2013;37(Suppl 1):S40-S4.

Health Canada. Diabetes in Canada: National Statistics and Opportunities for Improved Surveillance, Prevention and Control. Ottawa, Ontario, Health Canada; 1999. p. 1-69.

Public Health Agency of Canada. Report from the Canadian chronic disease surveillance system: hypertension Canada; 2010. Available from: http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/ccdss-snsmc-2010/1-eng.php. [Last accessed on 15 May 2014]

King AC, Rejeski WJ, Buchner DM. Physical activity interventions targeting older adults: A critical review and recommendations. Am J Prev Med 1998;15:316-33.

Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med 2007;32:419-34.

Goode AD, Reeves MM, Eakin EG. Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med 2012;42:81-8.

Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Bouter LM, et al. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Chronic Dis 1998;51:1235-41.

De Greef KP, Deforche BI, Ruige JB, Bouckaert JJ, Tudor-Locke CE, Kaufman JM, et al. The effects of a pedometer-based behavioral modification program with telephone support on physical activity and sedentary behavior in type 2 diabetes patients. Patient Education Counseling 2011;84:275-9.

Van Dyck D, De Greef K, Deforche B, Ruige J, Bouckaert J, Tudor-Locke CE, et al. The relationship between changes in steps/day and health outcomes after a pedometer-based physical activity intervention with telephone support in type 2 diabetes patients. Health Education Res 2013;28:539-45.

Eakin E, Reeves M, Lawler S, Graves N, Oldenburg B, Del Mar C, et al. Telephone counseling for physical activity and diet in primary care patients. Am J Prev Med 2009;36:142-9.

Eakin E, Reeves M, Winkler E, Lawler S, Owen N. Maintenance of physical activity and dietary change following a telephone-delivered intervention. Health psychology: official journal of the Division of Health Psychology. Am Psychological Assoc 2010;29:566-73.

Eakin EG, Reeves MM, Winkler E, Healy GN, Dunstan DW, Owen N, et al. Six-month outcomes from living well with diabetes: a randomized trial of a telephone-delivered weight loss and physical activity intervention to improve glycemic control. Annals Behavioral Med: Publication Soc Behavioral Med. 2013;46:193-203.

Eakin EG, Winkler EA, Dunstan DW, Healy GN, Owen N, Marshall AM, et al. Living well with diabetes: 24-month outcomes from a randomized trial of telephone-delivered weight loss and physical activity intervention to improve glycemic control. Diabetes Care 2014;37:2177-85.

Hordern MD, Coombes JS, Cooney LM, Jeffriess L, Prins JB, Marwick TH. Effects of exercise intervention on myocardial function in type 2 diabetes. Heart 2009;95:1343-9.

Kim CJ, Hwang AR, Yoo JS. The impact of a stage-matched intervention to promote exercise behavior in participants with type 2 diabetes. Int J Nursing Studies 2004;41:833-41.

Kirk A, Mutrie N, MacIntyre P, Fisher M. Increasing physical activity in people with type 2 diabetes. Diabetes Care 2003;26:1186-92.

Kirk A, Mutrie N, MacIntyre P, Fisher M. Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2 diabetes. Diabetologia 2004;47:821-32.

Kirk AF, Mutrie N, MacIntyre PD, Fisher MB. Promoting and maintaining physical activity in people with type 2 diabetes. Am J Prev Med 2004;27:289-96.

Marios T, Smart NA, Dalton S. The effect of tele-monitoring on exercise training adherence, functional capacity, quality of life and glycemic control in patients with type II diabetes. J Sports Sci Med 2012;11:51.

Plotnikoff RC, Karunamuni N, Courneya KS, Sigal RJ, Johnson JA, Johnson ST. The alberta diabetes and physical activity trial (ADAPT): a randomized trial evaluating theory-based interventions to increase physical activity in adults with type 2 diabetes. Annals Behavioral Med: Publication Soc Behavioral Med. 2013;45:45-56.

The expert committee on the diagnosis and classification of diabetes mellitus: report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2000;23:S4–S19.

Temple VA, Stanish HI. Pedometer-measured physical activity of adults with intellectual disability: predicting weekly step counts. J Inf 2009;114:15-22.

Welk GJ, Schaben JA, Morrow Jr JR. Reliability of accelerometry-based activity monitors: a generalizability study. Med Sci Sports Exercise 2004;36:1637-45.

Sookan T, McKune AJ. Heart rate variability in physically active individuals: reliability and gender characteristics: cardiovascular topics. Cardiovascular J Afr 2012;23:67-72.

Brown W, Trost S, Bauman A, Mummery K, Owen N. Test-retest reliability of four physical activity measures used in population surveys. J Sci Med Sport 2004;7:205-15.

Dubbert PM, Vander Weg MW, Kirchner KA, Shaw B. Evaluation of the 7-day physical activity recall in urban and rural men. Med Sci Sports Exercise 2004;36:1646-54.

Godin G, Shephard R. Godin leisure-time exercise questionnaire. Med Sci Sports Exercise 1997;29:S36.

Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 1994;6:284.

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Journal of Critical Reviews
Vol 2, Issue 4, 2015 Page: 6-11

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Authors & Affiliations

Cara Dhaliwall
Bachelor of Science in Kinesiology, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Room 403, 1400 Main Street West, Hamilton, ON L8S1C7, Canada. Fax

Erinmacpherson .

Julie Richardson


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