Experimental Program for Physical Activity Promotion - PEPAF


The goal of the trial was to evaluate the effectiveness of physician prescription of physical activity advice compared with standard care among primary care patients.


Physical activity advice would be more effective in improving physical activity.

Study Design

  • Randomized
  • Blinded
  • Parallel

Patients Enrolled: 16,663
Mean Follow Up: 6 months
Mean Patient Age: 49 years
Female: 67%

Patient Populations:

  • Primary care patients at least 18 years of age


  • Chronic or unstable medical condition that would preclude the safe participation in physical activity

Primary Endpoints:

  • Change in 6-month physical activity using the 7-day physical activity recall interview

Secondary Endpoints:

  • Maximum oxygen uptake
  • Health-related quality of life

Drug/Procedures Used:

Primary care physicians were randomized to an intervention group where they gave all their eligible patients physical activity advice (n = 8,574 patients) or standard care (n = 8,089 patients).

Principal Findings:

There was no difference in baseline characteristics between the groups. At baseline, the mean age was 49 years, 67% were women, 42% were overweight, and 26% were obese. The mean duration of moderate and vigorous activity was 34.4 minutes per week in the intervention group versus 33.2 minutes per week in the control group. Metabolic equivalents were 2.37 MET-hours per week versus 2.36 MET-hours per week, respectively.

At follow-up, the mean duration of moderate and vigorous activity was 82.6 minutes per week in the intervention group versus 65.1 minutes per week in the control group (p < 0.001 for between-group change). Metabolic equivalents were 5.70 MET-hours per week versus 4.42 MET-hours per week (p = NS), respectively. The proportion of the population that achieved physical activity recommendations was 3.9% higher in the intervention group (p < 0.05).


Among primary care patients, the prescription of physical fitness advice was associated with an increase in the duration of physical activity at 6-month follow-up. Metabolic equivalents achieved at follow-up were nonsignificantly increased with physical fitness advice. At a public health level, such a program may be useful in increasing physical activity levels in the population.


Grandes G, Sanchez A, Sanchez-Pinilla RO, et al. Effectiveness of physical activity advice and prescription by physicians in routine primary care: a cluster randomized trial. Arch Intern Med 2009;169:694-701.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Exercise

Keywords: Behavior Therapy, Follow-Up Studies, Overweight, Exercise, Physical Fitness, Metabolic Equivalent

< Back to Listings