Communication about physical activity in an underserved patient population

Abstract

17012 Background: Promoting physical activity may help reduce the incidence of several cancers. The 5A model, used to promote other patient behavior changes in clinical practice, may be applicable to physical activity. Our goal was to determine clinicians’ use of the 5A (Ask, Advise, Agree, Assist, Arrange) guidelines when communicating about physical activity and cancer risk with an underserved patient population. Methods: Analysis of 50 audiotaped transcribed office visits with adult patients and their clinicians in two community health centers in Rochester, NY. We conducted post-visit interviews to assess patient recall of communication about physical activity.We used descriptive statistics to assess patient demographics and the frequency of each of the 5As occurring in the audiotaped visits. Analysis of the transcripts of the visits explored other contextual factors related to use of the 5As for communication about physical activity and cancer risk. Results: Patients were predominantly female (70%) and were African American (50%), Caucasian (35%) and other/mixed ethnicity (15%). In the 50 office visits, there were twelve (24%) Ask, twelve (24%) Advise, three (6%) Agree, two (4%) Assist, and one (2%) Arrange statement. Physical activity communication was mostly (92%) clinician-initiated; the only discussion which included all 5As was patient-initiated. No discussion linked physical activity to cancer risk or cancer prevention. Patients recalling the most communication about physical activity with their clinician reported that it was contextualized to their specific health needs, included support and encouragement, and consisted of clear, simple advice. Conclusions: Communication about physical activity incorporating the Agree and Arrange steps of the 5As was infrequent. Cancer prevention interventions should target these steps and prompt the patient to initiate communication to improve physical activity in underserved populations. This project was supported by a grant from the National Cancer Institute, R25- CA102618. No significant financial relationships to disclose.