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The Activity Counseling Trial (ACT) was a multi-center study conducted between 1995 and 1997 in part by The Cooper Institute and was sponsored by the National Heart, Lung, and Blood Institute. The purpose of ACT was to develop and evaluate ways primary care physicians could implement physical activity counseling to sedentary patients in a clinical setting in an effort to increase and maintain their physical activity and cardiorespiratory fitness.


Participants were classified into three groups for men and three groups for women based on the amount or depth of counseling provided as evidenced below in Table 1.


TABLE 1. Counseling Groups and Level of Counseling Provided


Group 1: Standard Care Group 2: Staff Assisted
Group 3: Staff Counseling
Physician’s advice Physician’s advice Physician’s advice
Exercise advice by health educator Exercise advice by health educator Exercise advice by health educator
In-clinic counseling by health educator In-clinic counseling by health educator
Interactive mail Interactive mail
Telephone counseling


The participants included 395 female and 479 male sedentary primary care patients ages 35 to 75 years without cardiovascular disease.  Group 1 was the control group which received minimal intervention consistent with the standard of care for physician counseling.


In the ACT study, we evaluated cardiorespiratory fitness of all participants by measuring their maximal oxygen uptake (VO2 max) and assessing their self-monitored exercise logs after 24 months. We found that with increased level of counseling intervention, women responded with increased cardiorespiratory fitness over 2 years compared with the basic recommended standard of care.
However, our results further suggest that neither of the two levels of counseling interventions was more effective than the basic recommended standard of care.


Blair SN, Applegate WB, Dunn AL, Ettinger WH, Haskell WI, King AC, Morgan TM,Shih JH, Simons-Morton DB (for the Activity Counseling Trial Research Group). Activity Counseling Trial: Rationale, Design, and Methods. Med. Sci. Sports Exerc. Vol. 30. No.7. pp. 1097-1106, 1998.

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