Physical inactivity is connected to dozens of chronic health conditions, yet few health care systems routinely screen patients for it.

A recently published University of Iowa pilot study suggests that identifying inactive patients and connecting them directly with health coaching may help improve their health behaviors and outcomes.

“Physical inactivity is related to up to 40 chronic conditions,” says Lucas Carr, PhD, associate professor in the UI Department of Health, Sport, and Human Physiology. “Very few health care systems screen patients for physical inactivity. If you don’t measure something, it’s impossible to manage it.”

Participants in the study improved in several areas, including muscle-strengthening activity, daily calorie consumption, whole fruit and total protein intake, sleep, diastolic blood pressure, body weight, depressive symptoms, fatigue, general health, and quality of life.

The work builds on years of effort at the UI to make physical activity screening and referral a more routine part of patient care.

Previous research found that patients who reported higher levels of physical activity had a significantly lower risk of 19 chronic conditions, including cardiovascular disease, cancer, respiratory disease, and diabetes. The new study examined what can happen after patients identified as inactive through a simple screening process are connected with supportive resources.

The screening questionnaire is currently used during annual wellness visits in University of Iowa Health Care family medicine, internal medicine, and sports medicine clinics. Patients answer two questions during check-in, helping providers determine whether they are meeting physical activity recommendations.

Carr says the goal is to make it easier to identify patients who are inactive and interested in receiving help.

For the pilot study, 97 adults with cardiovascular disease risk factors completed a 12-week behavioral counseling intervention after being recruited primarily through the two-question clinical screening and referral process in local family medicine clinics.

The remotely delivered program included health education, health coaching, and a wearable activity and sleep monitor. The study also found strong retention and adherence: 85% of participants completed the program, and coaching session attendance was 98%.

During the program, patients participated in telehealth sessions with trained health coaches, all of whom were undergraduate students in the Department of Health, Sport, and Human Physiology. Before working with patients, the students completed coursework in areas such as physical activity, nutrition, lifestyle medicine, and health coaching and must pass a practical exam.

Carr says health coaching is centered on active listening, reflection, and problem-solving.

“It’s about asking: What has worked for you in the past? What hasn’t worked? What could we work on next to help you achieve your goals?” Carr says.

Carr hopes the model can eventually expand across more clinics and become a routine part of care. He also notes that UI Health Care is the first major health system in the U.S. to screen patients for both aerobic and muscle-strengthening activity.

The pilot study supports the feasibility and preliminary efficacy of the program, although a randomized controlled trial is needed to confirm the findings.