Reach and equity of primary care-based counseling to promote walking among the adult population of Spain

ObjectivesSome controlled trials have shown that brief counseling in primary care settings can increase walking. We examined the prevalence of primary care-based counseling to promote walking and assessed its reach and equity in Spain.DesignData were taken from a cross-sectional study conducted in 2008–2010 among 11,951 individuals representative of the non-institutionalized population aged 18-years and older in Spain.MethodsInformation on whether advice was received, adherence to advice, and time spent walking was self-reported. Analyses were adjusted for proxies of the need for physical activity (age, subjective health, and classic cardiovascular risk factors, including physical activity other than walking and body mass index), equity (sex and educational level), and factors enabling counseling (use of primary care services).ResultsOverall, 46.2% (95% confidence interval [CI] 45.0–47.4) of adults in Spain received counseling to promote walking. Older adults, those with worse subjective health, lower physical activity, with overweight or obesity, and higher use of primary care services were more likely to be counseled. For equal need, counseling was less frequent in men and those with lower socioeconomic position. A total of 69.2% (95% CI 67.8–70.6) of adults who received counseling reported following it. There was no difference in the time spent walking between those who received and did not receive counseling (+0.4 min/day; 95% CI −0.1 to 0.9).ConclusionsA substantial proportion of Spanish adults has been encouraged to walk by primary care physician and nurses, but counseling did not translate into longer walking time.