Does provider prevention orientation influence female patients' preventive practices?
BACKGROUND
Health care provider encouragement for particular preventive behaviors is associated with patient adherence, but it is unclear whether a provider's overall prevention approach influences whether patients engage in recommended preventive measures. We examined whether older women who perceived that their health care provider encouraged a particular preventive behavior were more likely to follow that recommendation if they also perceived that the provider encouraged other preventive behaviors.


METHODS
The sample included 1119 women aged 50 to 79 enrolled in a health maintenance organization. We examined associations of reported provider encouragement for post-menopausal hormone use, physical activity, fecal occult blood testing (FOBT), and flexible sigmoidoscopy with one another and with adherence to these measures according to recommended guidelines.


RESULTS
Among women reporting provider encouragement for physical activity, the likelihood of reporting regular physical activity was greater among women who reported encouragement for one other (odds ratio [OR]=1.99; confidence interval [CI]=1.35 to 2.95) and at least two other (OR=2. 38; 95% CI=1.62 to 3.48) preventive measures compared with women who reported no other encouragement. The likelihood of reporting adequate counseling for post-menopausal hormone use was greater among women reporting encouragement for at least two other preventive measures compared with those reporting no other encouragement. The likelihood of having had an FOBT or sigmoidoscopic examination was related to encouragement for those procedures, but not with greater encouragement for other preventive measures.


CONCLUSIONS
Patient perceptions of a provider's overall preventive practice approach may influence whether patients engage in recommended preventive practices, particularly for lifestyle factors.
Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. keg9@cdc.gov
K J
KJ
Greenlund
N L
NL
Keenan
L A
LA
Anderson
M T
MT
Mandelson
K M
KM
Newton
A Z
AZ
LaCroix
D000368:Aged; D000369:Aged, 80 and over; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006279:Health Maintenance Organizations; D006801:Humans; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care; D010819:Physician's Role; D010817:Physician-Patient Relations; D011315:Preventive Medicine; D012812:Sigmoidoscopy / Q000706:statistics & numerical data