title: Provider advice on exercise and diet among adults with comorbid serious psychological distress and diabetes or diabetes risk factors.
abstract: To examine the lifetime prevalence and correlates of provider advice to increase exercise and reduce dietary fat intake among adults with comorbid serious psychological distress (SPD) and diabetes or diabetes risk factors.
  
  
  
  Study sample (n = 5942) was selected from the Medical Expenditure Panel Survey Household Component (MEPS-HC) series of 2007-2011. SPD was defined as a score of ≥13 on the Kessler Psychological Distress Scale (K6). Multivariate logistic regression was used to examine correlates of lifetime provider advice.
  
  
  
  Less than half of adults with SPD had been advised to increase exercise (49.4%) or reduce dietary fat intake (45.6%). The prevalence of receiving provider advice increased in a linear fashion as the number of diabetes risk factors increased and was the highest among those with diabetes. Provision of provider advice was strongly associated with clinical factors rather than individuals' sociodemographic characteristics and current health behaviors.
  
  
  
  Health care providers are missing opportunities to provide exercise and low-fat dietary advice to patients with SPD before they manifest clinical risk factors associated with diabetes. It is important that providers counsel them as early as possible about exercise and nutritional changes that reduce the risks associated with diabetes.
authors.affiliation: University of Illinois at Urbana-Champaign, Urbana, Illinois (Ms Xiang, Dr Hernandez, Dr Larrison).
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Xiang
authors.affiliation: University of Illinois at Urbana-Champaign, Urbana, Illinois (Ms Xiang, Dr Hernandez, Dr Larrison).
authors.forename: Rosalba
authors.initials: R
authors.lastname: Hernandez
authors.affiliation: University of Illinois at Urbana-Champaign, Urbana, Illinois (Ms Xiang, Dr Hernandez, Dr Larrison).
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Larrison
mesh_terms: D000328:Adult; D015897:Comorbidity; D003376:Counseling / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000628:therapy*; D018752:Diet, Fat-Restricted; D015444:Exercise; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000628:therapy*