title: Modifying health behavior to prevent cardiovascular diseases: a nationwide survey among German primary care physicians.
abstract: Cardiovascular diseases (CVD) are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs) were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72%) and alcohol (61%) consumption, to encourage them to increase their levels of physical activity (72%), and to assist them in adjusting to a more healthy diet (66%), and in achieving a healthy body weight (69%). However, only between 23% (quitting smoking) and 49% (diet modification) of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany. sven.schneider@medma.uni-heidelberg.de.
authors.forename: Sven
authors.initials: S
authors.lastname: Schneider
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany. katharina.diehl@medma.uni-heidelberg.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Diehl
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany. christina.bock@medma.uni-heidelberg.de.
authors.forename: Christina
authors.initials: C
authors.lastname: Bock
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany. raphael.herr@medma.uni-heidelberg.de.
authors.forename: Raphael M
authors.initials: RM
authors.lastname: Herr
authors.affiliation: Internistic Group Practice Dr. med. Manfred Mayer und Dr. med. Angela Schmid, Max-Joseph-Str. 1, D-68167 Mannheim, Germany. mail@manfred-mayer.de.
authors.forename: Manfred
authors.initials: M
authors.lastname: Mayer
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167 Mannheim, Germany. tatiana.goerig@medma.uni-heidelberg.de.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Görig
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D005858:Germany; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires
references.citation: Am J Clin Nutr. 1997 Jun;65(6 Suppl):1957S-1962S
references.pmid: 9174503
references.citation: Dtsch Arztebl Int. 2010 Nov;107(46):817-23
references.pmid: 21151417
references.citation: Expert Rev Cardiovasc Ther. 2008 Jul;6(6):883-95
references.pmid: 18570625
references.citation: Gesundheitswesen. 2010 Apr;72(4):228-32
references.pmid: 19533584
references.citation: Med Care Res Rev. 2012 Oct;69(5):495-518
references.pmid: 22457269
references.citation: Cochrane Database Syst Rev. 2004;(1):CD003041
references.pmid: 14974003
references.citation: BMJ. 2011 Feb 22;342:d671
references.pmid: 21343207
references.citation: Med Care. 2004 Nov;42(11):1037-9
references.pmid: 15586829
references.citation: Circulation. 2007 Aug 28;116(9):1081-93
references.pmid: 17671237
references.citation: Circulation. 2005 Feb 1;111(4):499-510
references.pmid: 15687140
references.citation: Eur J Cardiovasc Prev Rehabil. 2006 Apr;13(2):137-49
references.pmid: 16575266
references.citation: J Cardiovasc Nurs. 2003 Sep-Oct;18(4):245-55
references.pmid: 14518600
references.citation: Arch Intern Med. 2009 Apr 13;169(7):659-69
references.pmid: 19364995
references.citation: J Phys Act Health. 2010 Sep;7(5):602-12
references.pmid: 20864755
references.citation: Dis Manag. 2005 Apr;8(2):93-105
references.pmid: 15815158
references.citation: Circulation. 2011 Nov 29;124(22):2458-73
references.pmid: 22052934
references.citation: Circulation. 2007 Dec 18;116(25):2933-43
references.pmid: 18071080
references.citation: Br J Gen Pract. 1999 Mar;49(440):187-90
references.pmid: 10343420
references.citation: Prev Med. 1995 Nov;24(6):546-52
references.pmid: 8610076
references.citation: J Hum Hypertens. 1995 Oct;9(10):835-9
references.pmid: 8576900
references.citation: Stroke. 2006 Jan;37(1):13-9
references.pmid: 16306464
references.citation: Prev Med. 1993 Jan;22(1):96-109
references.pmid: 8475015
references.citation: BMJ. 2004 Jun 26;328(7455):1519
references.pmid: 15213107
references.citation: BMC Cardiovasc Disord. 2013 Jun 01;13:38
references.pmid: 23725092
references.citation: Ann Epidemiol. 2007 May;17(5 Suppl):S16-23
references.pmid: 17478320
references.citation: Am J Prev Med. 1999 May;16(4):307-13
references.pmid: 10493287
references.citation: Br J Gen Pract. 1997 Nov;47(424):711-4
references.pmid: 9519516
references.citation: Fam Pract. 1999 Jun;16(3):250-4
references.pmid: 10439978
references.citation: Prev Med. 2008 Apr;46(4):358-63
references.pmid: 17950452
references.citation: BMC Fam Pract. 2008 Jul 08;9:42
references.pmid: 18611255
references.citation: Eur J Gen Pract. 2007;13(1):27-34
references.pmid: 17366291
references.citation: Am J Clin Nutr. 2004 May;79(5):913S-920S
references.pmid: 15113739
references.citation: Br J Gen Pract. 2000 Dec;50(461):1001-4
references.pmid: 11224956
references.citation: Br J Gen Pract. 1994 Oct;44(387):446-9
references.pmid: 7748632
references.citation: Eur J Gen Pract. 2012 Jun;18(2):86-91
references.pmid: 22548286
references.citation: Dtsch Med Wochenschr. 2012 Jan;137(1-2):17-22
references.pmid: 22180278
references.citation: Dtsch Med Wochenschr. 2011 Nov;136(45):2302-7
references.pmid: 22048935
references.citation: Fam Pract. 1999 Apr;16(2):158-63
references.pmid: 10381023
references.citation: J Natl Med Assoc. 2004 Aug;96(8):1080-3, 1088-91
references.pmid: 15303414
references.citation: Z Kardiol. 2004;93 Suppl 2:II26-32
references.pmid: 15021993
references.citation: JAMA. 2002 Oct 23-30;288(16):1994-2000
references.pmid: 12387651
references.citation: Eur J Public Health. 2005 Apr;15(2):140-5
references.pmid: 15941758
references.citation: Fam Pract. 2002 Dec;19(6):596-604
references.pmid: 12429661
references.citation: N Engl J Med. 2002 Sep 5;347(10):716-25
references.pmid: 12213942
references.citation: Health Aff (Millwood). 2007 Jan-Feb;26(1):38-48
references.pmid: 17211012
references.citation: Addiction. 2000 Oct;95(10):1505-23
references.pmid: 11070527
references.citation: Circulation. 2006 Feb 14;113(6):898-918
references.pmid: 16380542