title: Behavioral counseling for cardiovascular disease prevention in primary care settings: a systematic review of practice and associated factors.
abstract: Cardiovascular disease carries a substantial public health burden. Physician advice on modifying behavioral risk factors is effective, yet the practice of and factors associated with behavioral counseling in primary care have not been systematically investigated. The authors conducted a systematic review that identified 18 studies providing data on 6,338 physicians. The provision of preventive services differed by patients' individual risk. Physicians' counseling on smoking cessation was most commonly reported. The proportions of physicians counseling about nutrition and physical activity were notably lower and few physicians took further action by using more intensive counseling approaches. As studies were mainly based on self-reports, current delivery of preventive services may be overestimated. There is a need to increase the frequency of behavioral counseling in primary care settings, particularly for nutrition and physical activity, and to emphasize that counseling may also benefit individuals without cardiovascular disease risk factors.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. christina.bock@medma.uni-heidelberg.de
authors.forename: Christina
authors.initials: C
authors.lastname: Bock
authors.forename: Katharina
authors.initials: K
authors.lastname: Diehl
authors.forename: Sven
authors.initials: S
authors.lastname: Schneider
authors.forename: Curt
authors.initials: C
authors.lastname: Diehm
authors.forename: David
authors.initials: D
authors.lastname: Litaker
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D040242:Risk Reduction Behavior