Saturday, March 25, 2023
| Characteristic | No. | Level of activity,b no. (%) | |||
|---|---|---|---|---|---|
| Consistently inactive | Inconsistently active | Consistently active | P valuec | ||
| Entire sample of unique patients | 8,741 | 1,578 (18.1) | 4,218 (48.3) | 2,945 (33.7) | — |
| Patients with a single visit | 5,745 | 1,257 (21.9) | 2,171 (37.8) | 2,317 (40.3) | |
| Patients with ≥2 visits | 2,996 | 321 (10.7) | 2,047 (68.3) | 628 (21.0) | |
| Sex | |||||
| Female | 4,587 | 927 (20.2) | 2,312 (50.4) | 1,348 (29.4) | <.001 |
| Male | 4,154 | 651 (15.7) | 1,906 (45.9) | 1,597 (38.4) | |
| Age group at first visit, y | |||||
| 20–34 | 3,186 | 463 (14.5) | 1,534 (48.1) | 1,189 (37.3) | <.001 |
| 35–44 | 1,585 | 260 (16.4) | 788 (49.7) | 537 (33.9) | |
| 45–54 | 1,325 | 247 (18.6) | 650 (49.1) | 428 (32.3) | |
| 55–64 | 1,206 | 251 (20.8) | 577 (47.8) | 378 (31.3) | |
| 65–74 | 947 | 198 (20.9) | 455 (48.0) | 294 (31.0) | |
| ≥75 | 492 | 159 (32.3) | 214 (43.5) | 119 (24.2) | |
| BMI at first visitd | |||||
| Underweight (<18.5) | 146 | 35 (24.0) | 64 (43.8) | 47 (32.2) | <.001 |
| Normal (18.5–24.9) | 3,073 | 486 (15.8) | 1,434 (46.7) | 1,153 (37.5) | |
| Overweight (25.0–29.9) | 2,784 | 455 (16.3) | 1,312 (47.1) | 1,017 (36.5) | |
| Obese (≥30.0) | 2,535 | 555 (21.9) | 1,319 (52.0) | 661 (26.1) | |
| Race | |||||
| Asian | 1,146 | 230 (20.1) | 588 (51.3) | 328 (28.6) | <.001 |
| Black or African American | 569 | 156 (27.4) | 274 (48.2) | 139 (24.4) | |
| Othere | 227 | 54 (23.8) | 112 (49.3) | 61 (26.9) | |
| Unknown/declined to report | 1,560 | 250 (16.0) | 712 (45.6) | 598 (38.3) | |
| White | 5,239 | 888 (16.9) | 2,532 (48.3) | 1,819 (34.7) | |
| Ethnicity | |||||
| Not Hispanic or Latino | 6,584 | 1,220 (18.5) | 3,243 (49.3) | 2,121 (32.2) | <.001 |
| Hispanic or Latino | 409 | 94 (23.0) | 192 (46.9) | 123 (30.1) | |
| Unknown/declined to report | 1,748 | 264 (15.1) | 783 (44.8) | 701 (40.1) | |
| Modified Charlson Comorbidity Index scoref | |||||
| 0 | 6,929 | 1,137 (16.4) | 3,290 (47.5) | 2,502 (36.1) | <.001 |
| 1 | 902 | 193 (21.4) | 487 (54.0) | 222 (24.6) | |
| 2 | 483 | 115 (23.8) | 232 (48.0) | 136 (28.2) | |
| 3 | 161 | 50 (31.1) | 76 (47.2) | 35 (21.7) | |
| 4 | 83 | 20 (24.1) | 47 (56.6) | 16 (19.3) | |
| ≥5 | 183 | 63 (34.4) | 86 (47.0) | 34 (18.6) | |
Table. Distribution of Physical Activity Vital Sign (PAVS) Categories in a Sample of Patients in a Family Medicine Clinic, by Demographic Characteristics and Comorbidities, United States, 2018–2020a
Abbreviations: —, does not apply; BMI, body mass index.
a Percentages across row may not add to 100 because of rounding.
b Patients reporting 0 minutes per week of physical activity consistently in all clinic visits were classified as consistently inactive; patients reporting ≥150 minutes per week of physical activity in all visits were classified as consistently active; patients who reported physical activity rates that did not fit the above 2 categories consistently for all visits were classified as inconsistently active (<150 min/wk).
c χ2 test for independence of variables.
d 203 (2.3%) patients were missing BMI values; percentages are based on the number of patients who had data on BMI. BMI calculated as weight in kg divided by height in meters squared.
e “Other” includes American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, and multiple races.
f Score was calculated by using the International Classification of Diseases, Tenth Revision, Clinical Modification codes [13] for 17 health conditions from the 3 years before the first clinic visit with PAVS recorded. A higher Charlson Comorbidity Index score is generally associated with increased age, comorbidities, and all-cause mortality [11–13].
Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 1.00 ABIM MOC points
This activity is intended for primary care physicians, endocrinologists, and other physicians who advise patients about physical activity.
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Physical activity is important to prevent and manage multiple chronic medical conditions. The objective of this study was to describe the implementation of a physical activity vital sign (PAVS) in a primary care setting and examine the association between physical activity with demographic characteristics and chronic disease burden.
We extracted data from the electronic medical records of patients who had visits from July 2018 through January 2020 in a primary care clinic in which PAVS was implemented as part of the intake process. Data collected included self-reported physical activity, age, sex, body mass index, race, ethnicity, and a modified Charlson Comorbidity Index score indicating chronic disease burden. We classified PAVS into 3 categories of time spent in moderate to strenuous intensity physical activity: consistently inactive (0 min/wk), inconsistently active (<150 min/wk), and consistently active (≥150 min/wk). We used χ2 tests of independence to test for association between PAVS categories and all other variables.
During the study period, 13,704 visits, corresponding to 8,741 unique adult patients, had PAVS recorded. Overall, 18.1% of patients reported being consistently inactive, 48.3% inconsistently active, and 33.7% consistently active. All assessed demographic and clinical covariates were associated with PAVS classification (all P < .001). Larger percentages of consistent inactivity were reported for female, older, and underweight or obese patients. Larger percentages of consistent activity were reported for male, younger, and normal weight or overweight patients.
Using PAVS as a screening tool in primary care enables physicians to understand the physical activity status of their patients and can be useful in identifying inactive patients who may benefit from physical activity counseling.
