Physical Activity Research in Nursing

Purpose: To present exemplars of physical activity research in nursing, illustrate the importance of physical activity research across the lifespan, and recommend directions for theory development and research. Methods: Studies of physical activity and exercise currently being conducted by nurse investigators were reported and critiqued by attendees of the Midwest Nursing Research Society 2000 Preconference session entitled “Promoting Physical Activity Among Diverse Groups Across the Health Continuum.” Physical activity and exercise literature during the past decade was reviewed. Databases searched included Medline, CINAHL, Wilson, and ERIC. Findings: Investigators have emphasized the need to evaluate the effects of theory-based physical activity interventions designed to alter key correlates of physical activity identified through descriptive research. Conclusions: Regular physical activity is necessary for health promotion and disease prevention for all populations. Continued research in this important area of health behavior is critical to identify the most effective interventions to increase physical activity among diverse populations

Improving Fecal Occult Blood Testing Compliance Using a Mailed Educational Reminder

Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths in the United States. Randomized controlled trials have shown that annual screening fecal occult blood testing (FOBT) reduces CRC mortality and incidence. However, patient compliance with FOBT is low. To determine whether a mailed educational reminder increases FOBT card return rates and to examine predictors of FOBT compliance. Blinded, randomized, controlled trial at the Veteran Affairs Medical Center, San Diego, California. Seven hundred and seventy-five consecutive patients ≥50 years of age referred by their primary care physicians for FOBT. Patients were randomly assigned to the usual care group or the intervention group. Ten days after picking up the FOBT cards, a 1-page reminder with information related to CRC screening was mailed to the intervention group only. The primary outcome was proportion of returned FOBT cards after 6 months. Patient demographic, clinical characteristics and prior FOBT completed were collected for multivariate regression analysis. At 6 months after card distribution, 64.6% of patients in the intervention group returned cards compared with 48.4% in the control group (P < 0.001). Patients who received a mailed reminder (OR 2.02; 95% CI: 1.48–2.74) or have a prior history of returning the FOBT cards (OR 1.87; 95% CI: 1.29–2.70) were more likely to return the FOBT cards. Patients with current or recent illicit drug use were less likely to return the FOBT cards (OR 0.26; 95% CI: 0.13–0.50). A simple mailed educational reminder significantly increases compliance with FOBT for CRC screening

Insulin Sensitivity Following Exercise Interventions

Objective: Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. This comprehensive meta-analysis synthesized the insulin sensitivity outcomes of supervised exercise interventions. Method: Extensive literature searching located published and unpublished intervention studies that measured insulin sensitivity outcomes. Eligible studies tested supervised exercise interventions among healthy adults. Primary study characteristics and results were coded. Random-effects meta-analyses of standardized mean differences included moderator analyses. Results: Data were synthesized across 2509 subjects (115 samples, 78 reports). The overall mean effect size for 2-group postintervention comparisons was 0.38 (95% confidence interval [CI] = 0.25-0.51, I 2 = 0%) and for 2-group pre–post comparisons was 0.43 (95% CI = 0.30-0.56, I 2 = 52%; higher mean insulin sensitivity for treatment than control subjects). The postintervention mean of 0.38 is consistent with treatment subjects ending studies with a mean fasting insulin of 6.8 mU/L if control participants’ mean fasting insulin were 7.9 mU/L. Exploratory moderator analyses did not document different insulin sensitivity effect sizes across intervention characteristics or sample attributes. Conclusion: This study documented that exercise is a valuable primary care and community health strategy for healthy adults to improve insulin sensitivity and lower the risk for diabetes conferred by insulin resistance

Improving Fecal Occult Blood Testing Compliance Using a Mailed Educational Reminder

Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths in the United States. Randomized controlled trials have shown that annual screening fecal occult blood testing (FOBT) reduces CRC mortality and incidence. However, patient compliance with FOBT is low. To determine whether a mailed educational reminder increases FOBT card return rates and to examine predictors of FOBT compliance. Blinded, randomized, controlled trial at the Veteran Affairs Medical Center, San Diego, California. Seven hundred and seventy-five consecutive patients ≥50 years of age referred by their primary care physicians for FOBT. Patients were randomly assigned to the usual care group or the intervention group. Ten days after picking up the FOBT cards, a 1-page reminder with information related to CRC screening was mailed to the intervention group only. The primary outcome was proportion of returned FOBT cards after 6 months. Patient demographic, clinical characteristics and prior FOBT completed were collected for multivariate regression analysis. At 6 months after card distribution, 64.6% of patients in the intervention group returned cards compared with 48.4% in the control group (P < 0.001). Patients who received a mailed reminder (OR 2.02; 95% CI: 1.48–2.74) or have a prior history of returning the FOBT cards (OR 1.87; 95% CI: 1.29–2.70) were more likely to return the FOBT cards. Patients with current or recent illicit drug use were less likely to return the FOBT cards (OR 0.26; 95% CI: 0.13–0.50). A simple mailed educational reminder significantly increases compliance with FOBT for CRC screening