Abstract P117: Implementing the Physical Activity Vital Sign in an Academic Preventive Cardiology Clinic

Abstract

Background: Physical activity (PA) can protect against cardiovascular disease but it is not routinely assessed in clinical settings. The current PA recommendations are 150 minutes of moderate- or 75 minutes vigorous-intensity PA/week. Purpose: The purpose of this study was to implement physical activity screening as part of the electronic kiosk check-in process in an adult preventive cardiology clinic in an academic medical center and assess factors related to patients’ self-reported PA. Methods: The physical activity vital sign (PAVS) was embedded into the Epic electronic health record and includes 3 questions about the average days, minutes and intensity (light, moderate, vigorous) of PA per week. Analysis of patient records from a recent 60-day period included descriptive statistics, bivariate analyses and logistic regression to identify sociodemographic factors associated with not meeting current PA recommendations. Results: A total of 1,322 patients checked into the clinic using a kiosk. Patients were 42% female, 71% White, 62% married, had a mean age 64±15 years, 41% worked full-time and the majority (57%) were never smokers. The three most common primary diagnoses were hyperlipidemia (n=197), coronary artery disease (n=189), and hypertension (n=127). Of those patients, 72% (n=951) completed the PAVS questions:10% reported no PA; 55% reported some PA; and 35% reported achieving at least 150 minutes moderate or 75 minutes vigorous PA/week. In bivariate analyses (at recommended PA vs. not at recommended PA), factors associated with not achieving recommended levels of PA included sex (p<.001), race (p=.045), marital status (p<.001), and employment (p<.001). In the final logistic model, being female vs. male (OR=1.4, 95%CI: 0.99-1.8, p=.05), Black (OR=2.0, 95%CI: 1-3.7, p=.037) or ‘Other’ race (OR=1.5, 95%CI: 1-2.2, p=.04) vs. White, those reporting being partnered or in ‘other’ relationships vs. married (OR=.03, 95% CI: 0.14-0.55, p<.001), and those who were retired (OR=2, 95% CI: 1.4-2.8, p<.001) or unemployed (OR=2.2, 95%CI: 1.3-3.7, p=.002) vs. full-time workers were factors associated with not achieving recommended levels of PA. Conclusion: In a preventive cardiology clinic, only one-third reported achieving AHA recommended levels of PA. Our data support particular attention to PA counseling and prescription in female, Black, and retired or unemployed patients. Additionally, embedding the PAVS into a clinical electronic health system is a feasible and scalable intervention to collect data on this cardiovascular risk factor.