title: Challenges in making therapeutic lifestyle changes among hypercholesterolemic African-American patients and their physicians.
abstract: OBJECTIVE
  We explored challenges faced by hypercholesterolemic African-American primary care patients and their physicians regarding therapeutic lifestyle changes (TLC) and provide patient-influenced recommendations to physicians.
  
  
  METHODS
  In this qualitative study, 23 urban family medicine patients and their physicians (N=12) participated in separate focus groups, where they were asked semistructured, open-ended questions about knowledge and barriers to lifestyle treatment of high cholesterol.
  
  
  RESULTS
  During the focus groups, barriers mentioned by physicians were: lack of time for TLC counseling, inadequate knowledge about counseling patients, and patient readiness and responsibility to change. Patient-revealed barriers included difficulty adhering to a diet/exercise regimen and a lack of knowledge about high cholesterol. Patients who were successful with adopting a healthy lifestyle identified personal experiences or those of family and friends as motivating.
  
  
  CONCLUSIONS
  Physicians desire training and resources to better help patients adopt diet and exercise regimens specific to their general and health literacy and their access to healthy foods, along with their readiness to change. Patients desire that physicians tailor their TLC advice to be specific to their context and they want help from physicians in setting realistic goals. Such a patient-centered counseling approach may improve adherence to lifestyle guidelines and, thus, clinical outcomes.
authors.affiliation: Department of Family Medicine, Wayne State University, Detroit, MI 48201, USA. rdailey@med.wayne.edu
authors.forename: Rhonda
authors.initials: R
authors.lastname: Dailey
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Schwartz
authors.forename: Juliann
authors.initials: J
authors.lastname: Binienda
authors.forename: Jessica
authors.initials: J
authors.lastname: Moorman
authors.forename: Anne Victoria
authors.initials: AV
authors.lastname: Neale
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D005194:Family Practice; D005260:Female; D017144:Focus Groups; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006937:Hypercholesterolemia / Q000208:ethnology / Q000517:prevention & control*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D014481:United States