Abstract P420: Healthcare Providers as Role Models for Physical Activity

Abstract

Background. Health care providers (HCPs) are in a privileged position to give credible advice on healthy lifestyles, including physical activity (PA) promotion, a national public health objective (Healthy People 2020). It has been reported that HCPs own habits matter in their counseling practices. Active HCPs that comply with PA guidelines are more likely to counsel and give more motivating PA advice to their patients. Objectives. The purpose of this literature review was to summarize the evidence on the association between HCPs personal PA habits and their related counseling practices on PA Methods. Search terms such as “attitudes”, “habits”, “health personnel", "physical activity", “exercise", and “role model” were used to identify relevant articles. On-topic articles were retrieved and a snow ball literature search methodology was used to select the most relevant articles in PubMed between 1979 and 2012. Articles were hand-picked and organized by type: observational vs intervention. Results. A total of 196 articles were retrieved: 23 were descriptive studies of HCP habits or counseling, and 28 studies (24 observational and 4 interventions) suggested HCPs personal PA habits influence their counseling behavior and attitudes towards PA. The majority of studies were from the US (n=21). Seven included non-physician population (nurses, pharmacists and other HCPs). The most frequent PA assessment method was self-reported questionnaires. For counseling behaviors, studies measured perceived frequency or self-efficacy for their practice. All but one of the 24 observational studies found significant associations between HCPs personal PA or fitness levels and the behaviors towards related PA counseling. This association was observed among physicians (n=15) and non-physicians (n=6) and also among medical (n=6) and nursing (n=1) students. Four observational studies reported physicians PA to be an independent effect for counseling (OR = 5.72, 3.4, 3.2, 1.1, 2.44 p < 0.05). Three studies showed a significant correlation between PA habits of HCP and their perceived frequency for counseling (r = 0.25 - 0.37). Among the 4 interventions found, only one focused on improving medical students’ PA habits and reported a significant association between improved physicians’ PA levels and counseling (OR 1.56 CI 1.04, 2.34; p= 0.03). Conclusion. HCPs own PA habits are an independent predictor of PA counseling practices. Interventions to improve HCPs PA habits have the potential to also improve HCPs PA counseling to patients. More research is needed in particular among non-physician populations and in low-to-middle income countries settings where the burden of inactivity is greatest.