Role of Nurses in Community-based Physical Activity Promotion: A Systematic Review

The purpose of this systematic review is to describe community and home-based physical activity (PA) interventions delivered by nurses and determine intervention attributes associated with positive PA changes.

 A systematic search was conducted through CINAHL, PubMed, PsycINFO, SportDiscus, Cochrane. Key words included physical activity or exercise or walking and community or home. Titles and abstracts were screened independently by two reviewers for inclusion criteria: published in English between 1990-2014, used a nurse-delivered intervention delivery and directly measured overall PA, exercise, or walking.

 Initial search yielded 2,720 citations. After removing duplicates, screening titles and abstracts and reading full-texts, 18 studies remained. Three additional studies were identified through ancestry searches. The final sample included 21 articles (13 in community settings and 8 in home settings).

 Twelve studies were conducted in the U.S. and 11 were guided by health behavior theories. All interventions included multiple contacts. The role of nurses varied including: leading exercise training or monitoring programs, counseling, and providing motivational communication. The most common role involved goal setting and monitoring. Eighteen studies (8 home setting; 10 community settings) reported greater PA change in intervention subjects.

 A previous review focusing on nurse-delivered PA interventions in primary care had less consistent findings, suggesting community and home settings may be more effective in promoting PA behavior change. These findings may indicate that nurses in home and community settings may foster more therapeutic relationships resulting in more positive behavior change. In addition, time constraints may be less of an issue than in primary care settings.