Relationships between public health nurse-delivered physical activity interventions and client physical activity behavior

Aim: The purpose of this study was to identify physical activity interventions delivered by public health nurses (PHNs) and examine their association with physical activity behavior change among adult clients. Background: Physical activity is a public health priority, yet little is known about nurse-delivered physical activity interventions in day-to-day practice or their outcomes. Methods: This quantitative retrospective evaluation examined de-identified electronic-health-record data. Adult clients with at least two Omaha System Physical activity Knowledge, Behavior, and Status (KBS) ratings documented by PHNs between October 2010-June 2016 (N = 419) were included. Omaha System baseline and follow-up Physical activity KBS ratings, interventions, and demographics were examined. Results: Younger clients typically receiving maternal-child/family services were more likely to receive interventions than older clients (p < 0.001). A total of 2869 Physical activity interventions were documented among 197 clients. Most were from categories of Teaching, Guidance, Counseling (n = 1639) or Surveillance (n = 1183). Few were Case Management (n = 46). Hierarchical regression modeling explained 15.4% of the variance for change in Physical activity Behavior rating with significant influence from intervention dose (p = 0.03) and change in Physical activity Knowledge (p < 0.001). Conclusion: This study identified and described physical activity interventions delivered by PHNs. Implementation of department-wide policy requiring documentation of Physical activity assessment for all clients enabled the evaluation. A higher dose of physical activity interventions and increased Physical activity knowledge were associated with increased Physical activity Behavior. More research is needed to identify factors influencing who receives interventions and how interventions are selected.