title: Health-promoting environments in U.S. medical facilities: physician perceptions, DocStyles 2012.
abstract: OBJECTIVE
  Medical facilities are natural leaders for health promotion because of their mission, influence, and reach. We sought to determine the frequency of physicians reporting supportive, health-promoting environments in their facility and identify characteristics of physicians and medical practices associated with support.
  
  
  METHODS
  We analyzed a sample of 1485 U.S. primary care physicians in DocStyles 2012 survey. Physicians rated their facility's support for healthy nutrition, physical activity, and lactation environments. Frequencies and adjusted odds ratios for supportive environments (rated "Good" or "Very Good") were assessed by select characteristics.
  
  
  RESULTS
  The frequency of physicians reporting supportive environments was 70.0% for nutrition, 60.0% for physical activity, 76.0% for lactation, and 40.4% for all 3 environments combined. Supportive nutrition [odds ratio: 2.91 (1.49-5.66)] and physical activity [2.13 (1.19-3.83)] environments were associated with physicians seeing upper middle class to affluent patients versus poor patients. Supportive lactation environments were associated with pediatricians [3.35 (2.14-5.25)] and obstetricians/gynecologists [3.39 (2.15-5.33)] versus internists.
  
  
  CONCLUSIONS
  Less than half of physicians reported their facility supportive of all these environments, suggesting there are many missed opportunities for U.S. medical facilities to promote wellness. Facilities serving poor patients and those staffed by internists and family/general practitioners may represent one area of need.
authors.affiliation: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; The CDC Experience Applied Epidemiology Fellowship, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA; Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: iangoldstein1@gmail.com.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Goldstein
authors.affiliation: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Foltz
authors.affiliation: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Onufrak
authors.affiliation: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Brook
authors.initials: B
authors.lastname: Belay
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001942:Breast Feeding; D004032:Diet; D004779:Environment Design; D015444:Exercise; D005260:Female; D006268:Health Facilities; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care; D011322:Primary Prevention / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States
keywords: Breastfeeding; Food; Health facility environment; Hospital; Physical activity