DETERMINANTS OF PHYSICAL ACTIVITY AND DIETARY COUNSELING BY PHYSICIANS AT A LARGE LOW-INCOME CLINIC IN LOS ANGELES COUNTY.

Abstract

Purpose Studies have shown that the burden of chronic disease due to poor diet and physical inactivity falls disproportionately on the underserved. Although brief physician counseling have demonstrated efficacy for reducing these modifiable risk behaviors, little is known about factors that influence the receipt of these services in the low-income clinic setting. This study addresses this scientific gap. Methods A 94-question, multiple-item Patient Health Assessment Survey was distributed to 475 adult patients at four clinic sites within the Venice Family Clinic (VFC) system. The survey was administered to selected participants from November 2005 to January 2006 in the waiting room of each clinic. The instrument collected information on patient demographics, self-reported health risk behaviors, and receipt of various lifestyle-counseling services. Statistical analyses were performed using the STATA 9.0 statistical software package. Results Adult patients who were more likely to receive physical activity counseling included individuals who ate a relatively healthier diet, earned an annual income of over $38,000, were overweight/obese, and whose native language was Spanish. Similarly, adult patients who were more likely to receive dietary counseling included individuals who ate a relatively healthier diet, were female, were physically active, and whose native language was Spanish. Adult patients who were less likely to receive physical activity and dietary counseling had substance use problems, such as excess alcohol use and drug abuse. Adult patients9 chronic disease status, defined specifically in this study as cardiovascular disease, hypertension, diabetes, and depression, did not influence the receipt of either physical activity or dietary counseling. Conclusion Clinic-based interventions targeting physical activity and dietary behaviors should tailor their designs to addressing clinical and socioeconomic factors that influence the receipt of counseling services in the low-income clinic setting.