Which patients receive advice on diet and exercise? Do certain characteristics affect whether they receive such advice?
OBJECTIVE
To examine whether patients' characteristics, familiarity with the clinic, or perspectives on the quality of their care predict whether they receive advice from physicians regarding diet and exercise.


METHODS
Secondary data analysis of responses to the Primary Care Practice Survey.


METHODS
Capital District Health Authority in Nova Scotia.


METHODS
Residents of the Capital District Health Authority 18 years old and older (N = 1562).


METHODS
Percentage of patients who reported frequently receiving advice from their family physicians regarding diet and exercise.


RESULTS
Almost 38% of respondents reported frequently receiving advice from their physicians on diet. Those more likely to receive advice on diet were male (adjusted odds ratio [AOR] 1.6, 95% confidence interval [CI] 1.2 to 2.1), were 35 to 54 years old (compared with those aged 18 to 34) (AOR 1.5, 95% CI 1.1 to 2.2), had more chronic illnesses (AOR 1.3, 95% CI 1.2 to 1.6), had good relationships with their health care providers (AOR 2.3, 95% CI 1.8 to 3.1), or reported higher scores on an enablement scale (AOR 2.2, 95% CI 1.6 to 3.1). Respondents who reported their health status as excellent were less likely to receive advice on diet (AOR 0.5, 95% CI 0.3 to 0.9). About 42% of respondents reported frequently receiving advice on exercise. Men (AOR 1.7, 95% CI 1.3 to 2.2), those older than 35 years (AOR 1.7, 95% CI 1.2 to 2.4 for those aged 35 to 54; AOR 1.6, 95% CI 1.1 to 2.3 for those 55 and older), those rating their health as good (AOR 1.6, 95% CI 1.1 to 2.4), those with more chronic illnesses (AOR 1.3, 95% CI 1.1 to 1.5), and those reporting higher scores on communication (AOR 3.2, 95% CI 2.3 to 4.4) and enablement (AOR 1.8, 95% CI 1.3 to 2.4) scales were more likely to receive advice on exercise.


CONCLUSIONS
Strategies to increase the number of patients who receive advice on diet and exercise would likely include enhancing communication between patients and their physicians, improving relationships between patients and their physicians, and improving physicians' ability to help their patients feel enabled to act on advice and cope with their illnesses. Physicians should be aware of their counseling practices and consider discussing healthy behaviour with patients with no obvious risk factors. This would be practising true primary prevention.
Sinclair
Jennifer
J
Dalhousie University, Department of Family Medicine, Abbie J. Lane Bldg, 8th Floor, 5909 Veterans Memorial Lane, Halifax, Canada.
Lawson
Beverley
B
Burge
Fred
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003376:Counseling; D004032:Diet; D015444:Exercise; D005194:Family Practice; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011320:Primary Health Care