Abstract MP36: Trends and Correlates of Physical Activity and Dietary Counseling for Adults With Cardiovascular Risk Factors: Medical Expenditure Panel Survey 2002-20015

Abstract

Background: In 2014 the United States Preventive Services Task Force (USPSTF) recommended offering overweight adults with additional cardiovascular disease (CVD) risk factors behavioral counseling to promote a healthful diet and physical activity (PA). Methods: Self-reported receipt of counseling, CVD risk (overweight/obesity, diabetes, smoking, high cholesterol and blood pressure) for adults were extracted from the Medical Expenditure Panel Survey (MEPS) household component (HC) 2002-2015. Prevalence rates for PA+diet counseling were calculated, adjusted by age, gender, insurance type, race/ethnicity, region, marital status, educational level, family income, number of health visits and CVD risk factors. To assess trends, we computed prevalence ratios (PR) at three time-points: 2002/03, 2009/10 and 2014/15, controlling for socio-demographics. Correlates of PA/diet counseling for 2014/15 were explored using adjusted PR. Results: The MEPS-HC response rate averaged 57.1% and included 116,048 observations across the 14-year period. The adjusted PA/diet counseling prevalence ranged from 43% to 63% (Figure 1). Compared to the 2002/03, PA+diet counseling increased in 2009/10 (PR=1.09 (1.07-1.12)). In 2014/15, compared to adults with private insurance, those with no insurance or Medicare reported lower PA+diet counseling (PR=0.91 (0.84-0.99); PR=0.77; (0.73-0.82), respectively). Females (PR=1.07 (1.03-1.11) and racial minorities reported higher PA+diet counseling (PR=1.31 (1.24-1.38); PR=1.11 (1.05-1.18); PR=1.12 (1.01-1.24), for Hispanic, Black and Asians, respectively). Compared to adults with 2 CVD risk factors, those with 3, 4 or 5 CVD risk factors reported higher PA+diet counseling (PR=1.46 (1.39-1.54); PR=1.74 (1.63-1.85); PR=1.89 (1.67-2.15), respectively). Conclusions: Modest increases in PA and diet counseling have occurred, primarily before ACA passing. However, half of eligible patients report not receiving counseling, particularly those with no insurance or Medicare.