Advice on exercise from a family physician can help sedentary patients to become active

Objectives: To test the effectiveness, in the setting of primary health care, of verbal advice on exercise from a family physician (FP) combined with supporting written information. Design: A controlled trial with subjects allocated to a control group or one of two intervention groups using a balanced design based on day of the week. Setting: Ten general practices in Perth, Western Australia. Subjects: All sedentary patients consulting an FP. Intervention: Verbal advice on exercise from the FP and a pamphlet on exercise mailed to the patient's home address within 2 days of his/her visit to the doctor. Main outcome measure: Level of physical activity at followup. Results: 6,351 adult patients attending an FP practice completed a screening questionnaire, and 763 sedentary adults were recruited to the project. The response to follow-up, via a postal survey at 1, 6, and 12 months after the index consultation was 70%, 60%, and 57%, respectively. At 1 month a subsample of the control and intervention subjects were contacted for a telephone interview to verify self-reported levels of activity (n = 136). Treating all nonresponders as sedentary, at 1 month significantly more subjects in the combined intervention groups reported doing some physical activity (40%) compared with the control group (31%). Similarly, at 6 months, 30% of the control group and 38% of the combined intervention groups were now active. There was very little change at followup at 12 months (31% control and 36% intervention groups, respectively). Conclusion: A simple intervention aimed at the promotion of physical activity to sedentary patients in general practice can help reduce inactivity.

Factor analysis of the self-report Dysexecutive (DEX-S) Questionnaire

The self-rating Dysexecutive Questionnaire (DEX-S) is a recently developed standardized self-report measure of behavioral difficulties associated with executive functioning such as impulsivity, inhibition, control, monitoring, and planning. Few studies have examined its construct validity, particularly for its potential wider use across a variety of clinical and nonclinical populations. This study examines the factor structure of the DEX-S questionnaire using a sample of nonclinical (N = 293) and clinical (N = 49) participants. A series of factor analyses were evaluated to determine the best factor solution for this scale. This was found to be a 4-factor solution with factors best described as inhibition, intention, social regulation, and abstract problem solving. The first 2 factors replicate factors from the 5-factor solutions found in previous studies that examined specific subpopulations. Although further research is needed to evaluate the factor structure within a range of subpopulations, this study supports the view that the DEX has the factor structure sufficient for its use in a wider context than only with neurological or head-injured patients. Overall, a 4-factor solution is recommended as the most stable and parsimonious solution in the wider context.