Physician Counseling For Lifestyle Change

Abstract

Most U.S. adults visit a physician at least once each year, and because physician advice is highly valued, the health care system is an optimal environment for influencing lifestyle changes. Less is known, however, about the prevalence and correlates of physician advice for lifestyle changes in African Americans who do not meet current recommendations for physical activity (PA), fruit and vegetable (F&V) consumption, and weight. PURPOSE To determine the prevalence of physician advice for healthy lifestyle changes in African Americans who do not meet recommendations for PA, F&V intake, and weight. To examine the association between physician advice and diagnosed health conditions (i.e., overweight, CVD, diabetes, cancer, high BP, and high cholesterol), age, and gender. To assess the association between physician advice and stage of change for each of these health behaviors. METHODS Telephone surveys were used to assess the study variables. Chi square analyses assessed the relationship between physician advice and diagnosed health conditions, age, and gender; and the association between advice and stage of change for each of the behaviors. RESULTS Among those not meeting recommendations, 53.8% were advised to be more physically active, 39.1% were told to eat more F&Vs, and 39.7% were advised to maintain or lose weight. Patients diagnosed with ≥ 3 health conditions were more likely to receive advice for moderate PA (p = .002), F&V intake (p = .002), and weight (p = .02). Age was not associated with physician advice for moderate (p = .48) or vigorous PA (p = .63), F&V intake (p = .39), or weight loss (p = .59). Women were more likely than men to be advised about their weight (p = .006) but were no more likely to be advised to increase moderate PA (p = .35), vigorous PA (p = .18) or F&Vs (p = .07). Furthermore, for women, physician advice was associated with higher stage of change for moderate PA (p = .001), vigorous PA (p = .002), F&V intake (p < .001) and weight loss (p = .001). For men, physician advice was not associated with stage of change for moderate (p = .57) or vigorous (p = .24) PA, F&V intake (p = .27), or weight loss (p = .14). CONCLUSIONS Overall, self-reported physician advice for lifestyle changes in African Americans not meeting recommendations was low. Physician advice was more likely for patients diagnosed with ≥ 3 health conditions and women. For women (but not men) physician advice was associated with higher stage of change for moderate and vigorous PA, weight loss, and F&V intake. Thus, because of the preventive benefit of PA, F&Vs, and healthy weight, physicians need to increase counseling for all patients.