Physical Activity Counseling By Primary Care Physicians Is A Function Of Attitudes

Abstract

Since older adults rely heavily on the primary care physician (PCP) for lifestyle counseling, the PCP could be a potentially important vehicle for delivering physical activity counseling. Healthy People 2010 recommends that 85% of PCPs counsel patients about physical activity. Currently, the frequency and quality of physical activity counseling by the PCP is not well documented and appears to be less than adequate. PURPOSE This study explored the determinants and barriers to counseling on physical activity by South Carolina PCPs. METHODS A mail survey was distributed to all PCPs in South Carolina (N=2,766). The response rate was 22%. The survey consisted of 34 questions designed to obtain information on physician' demographics, current practices, attitudes, and barriers to physical activity counseling. An attitude scale was created by assigning a numerical value to each attitude response; scores ranged from 7–35. Higher attitude scores were indicative of more positive attitudes. A similar barrier scale was also created. Scores ranged from 0–27; lower scores indicated fewer perceived barriers to activity counseling. Data were analyzed using descriptive statistics and one-way ANOVAs. RESULTS Attitude scores were positively related to both frequency of asking patients about physical activity and method of counseling. Physicians with more positive attitudes tended to ask patients about physical activity at every visit and provide written exercise prescription or supplemental materials. Physicians with more positive attitudes also tended to recommend physical activity to all patients regardless of condition or disease and personally met the ACSM recommendations for activity. In general, PCP's with more positive attitude scores also perceived fewer barriers to counseling. CONCLUSION Attitude is a significant factor affecting the nature and extent of counseling of older patients about physical activity by primary care physicians. These data suggest that changing a physicians' attitude with respect to physical activity and its importance could play an integral role in improving the quality and quantity of counseling. Supported by Geriatric Academic Career Award #5 KO1 HP00035-03