Abstract
This study aimed to examine the amount of lifestyle counseling that Dutch general practitioners (GPs) generally provide to their patients, as well as the behavioral determinants of their lifestyle counseling practices. Lifestyle counseling was defined and operationalized through the 5As model (i.e. Assess, Advise, Agree, Assist and Arrange), while determinants were based on an adapted version of the theory of planned behavior. A cross-sectional study was conducted among a sample of 198 GPs, using an online survey questionnaire for collecting data. The results showed that 79.3% of the GPs assessed patients' current lifestyle often or always, while 60.1% reported they often or always assessed patients' motivation to improve their lifestyle. Depending on the lifestyle behavior, Advising to improve lifestyle ranged from 42.5% (sleep) to 92.4% (smoking), while Agree to set goals ranged from 21.7% (sleep) to 46.9% (smoking). Assisting patients to overcome barriers to lifestyle changes varied per patient barrier, ranging from lack of financial resources (25.7%) to stress (81.8%). The findings from the linear hierarchical regression revealed that GPs' self-efficacy (β = .46, p < .001), patient norm (β = .21, p < .001), and attitude (β = .20, p < .05) were the determinants with the strongest associations with lifestyle counseling. The full model explained 47% of the variance in counseling lifestyle. Implications for supporting GPs to counsel patients about their lifestyle are discussed.
Highlights
Chronic diseases are estimated to account for 90% of all deaths in the Netherlands [1] with cancer, cardiovascular diseases, respiratory diseases, and Alzheimer’s and other dementias as the leading causes of death [2]
Given the role of behavioral risk factors in developing these chronic diseases [3], lifestyle is recognized as an important factor that should be addressed in their prevention [4]
Cross-sectional data were collected by inviting general practitioners (GPs) to participate in a self-administered survey questionnaire study
Summary
Chronic diseases are estimated to account for 90% of all deaths in the Netherlands [1] with cancer, cardiovascular diseases, respiratory diseases, and Alzheimer’s and other dementias as the leading causes of death [2]. Given the role of behavioral risk factors in developing these chronic diseases [3], lifestyle is recognized as an important factor that should be addressed in their prevention [4]. A healthy lifestyle is defined as: ‘a way of living that lowers the risk of being seriously ill or dying early [5], usually referring to health behaviors that include nutrition, physical activity, sleep, stress, tobacco use and alcohol use [6]. Determinants of lifestyle counseling by Dutch general practitioners. The last section of the questionnaire measured the following background variables: age, gender, number of working days, postal code of practice, the type of practice, and whether they know ‘Arts en Leefstijl’ and/or are a member. The same holds for knowing or being member of ‘Vereniging Arts en Leefstijl’, as it is likely that members counsel lifestyle more often than the non-members. Mean item scores were averaged into a single score per determinant, after checking scale reliability by calculating Cronbach’s alpha
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