Prevalence and correlates of doctor-geriatric patient lifestyle discussions: analysis of ADEPT videotapes.
BACKGROUND
This study identifies the prevalence and correlates of physician-geriatric patient discussions about physical activity and nutrition lifestyle behaviors.


METHODS
Between August 1998 and July 2000, 423 older patient visits to 36 physicians were videotaped in three different primary care settings. The patient sample was primarily white, female, well-educated, and financially sufficient, although 12.7% of the encounters occurred in an inner city clinic. The major dependent variable-lifestyle discussion-is based on observations of physician behavior. Descriptive and multivariate logistic regression analyses were conducted in 2004.


RESULTS
Nutrition talk was most prevalent, occurring in almost half the encounters (48.2%) followed by physical activity discussions (39.2%) then conjoint mention (22%). Discussions were significantly less likely to occur in acute visits. While ethnicity, gender, and length of visit were not significantly related, physician interaction style and patient vitality and education were significant predictors in the multivariate analyses.


CONCLUSIONS
Given the impact of lifestyle behaviors on myriad health outcomes, the current prevalence rates of physician discussion, while higher than in many previous studies, remain sub-optimal. Practical assessment tools, training in behavioral counseling, and reimbursement incentives are recommended strategies for raising physical activity and nutrition discussion prevalence in primary care settings.
Ory
Marcia G
MG
Department of Social and Behavioral Health, School of Rural Public Health, Texas A&M University System Health Science Center, TAMU 1266, College Station, TX 77843-1266, USA. mory@srph.tamhsc.edu
Yuma
Paula J
PJ
Hurwicz
Margo-Lea
ML
Jarvis
Crystal
C
Barron
Kate L
KL
Tai-Seale
Tom
T
Tai-Seale
Ming
M
Patel
Dhaval
D
Hackethorn
David
D
Bramson
Rachel
R
Street
Richard
R
Cook
Mary Ann
MA
D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D005853:Geriatrics / Q000379:methods* / Q000592:standards; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009751:Nutritional Requirements; D010353:Patient Education as Topic / Q000379:methods*; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D011787:Quality of Health Care; D014481:United States; D014743:Videotape Recording