Active Choices
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Active Choices


Developed by: Stanford Prevention Research Center , distributed by Stanford Health Promotion Resource Center
Contact person: Cynthia M. Castro, Ph.D., Program Developer & Trainer,(650) 498-7281


Active Choices is a six-month physical activity program that helps individuals incorporate preferred physical activities in their daily lives. The program is individualized for each person. Staff or volunteers are trained to provide regular, brief telephone-based guidance and support, and mail follow-up is delivered to participants’ homes.

Supporting Evidence:

Four community-based organizations implemented Active Choices, a six-month, telephone-based program, and five implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active.
Participants completed pretest and posttest surveys. Participants (n=838) were aged an average of 68.4 ±9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys.

Intent-to-treat analyses found the following:

  • Statistically significant increases in moderate-to-vigorous physical activity and total physical activity.
  • Decreases in depressive symptoms and stress.
  • Increases in satisfaction with body appearance and function.
  • Decreases in body mass index.

Subsequent Research:

Subsequent research utilized a randomized, controlled trial design to determine the health and quality-of-life effects of moderate-intensity exercise among older women family caregivers.

The study involved a volunteer sample of 100 women aged 49 to 82 years who were sedentary, free of cardiovascular disease, and caring for a relative with dementia.
Participants were randomized to 12 months of home-based, telephone-supervised, moderate-intensity exercise training or to an attention-control (nutrition education) program. Exercise consisted of four 30- to 40-minute endurance exercise sessions (brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate.
Main outcomes were stress-induced cardiovascular reactivity levels, rated sleep quality, and reported psychological distress.

Compared with nutrition participants (NU), exercise participants (EX) showed significant improvements in the following: 

  • Total energy expenditure (baseline and post-test means [SD] for EX = 1.4 [1.9] and 2.2 [2.2] kcal/kg/day; for NU = 1.2 [1.7] and 1.2 [1.6] kcal/kg/day; p < .02).
  • Stress-induced blood pressure reactivity (baseline and post-test systolic blood pressure reactivity values for EX = 21.6 [12.3] and 12.4 [11.2] mm Hg; for NU = 17.9 [10.2] and 17.7 [13.8] mm Hg; p < .024).
  • Sleep quality (p < .05).

NU showed significant improvements in percentages of total calories from fats and saturated fats relative to EX (p values < .01). Both groups reported improvements in psychological distress.


Griffin SF, Wilcox, S, Ory MR, Lattimore D, Leviton L, Castro C, Carpenter RA, Rheaume C. Results from the Active for Life Process evaluation: delivery fidelity and adaptations. Health Educ. Res. (2010) 25 (2):325-342. [Online]:

Wilcox, S, Dowda M,Griffin SF, Rheaume C, Ory MG, Leviton L, King AC, Dunn A, Buchner DM, Bazzarre T, Estabrooks PA, Campbell-Voytal K, Bartlett-Prescott J, Dowdy D, Casto CM, Carpenter RA, Dzewaltowski DA, Mockenhaupt R. Results of the First Year of Active for Life: Translation of 2 Evidence-Based Physical Activity Programs for Older Adults Into Community Settings. Amer Journal of Public Health. (July 2006) 96 (7): 1201-1209. [Online]:

King AC, Baumann K, O’Sullivan P, Wilcox S, Castro C. Effects of Moderate-Intensity Exercise on Physiological, Behavioral, and Emotional Responses to Family Caregiving: A Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci. (2002) 57 (1): M26-M36. [Online]:

Active Choices


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