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Factors underlying variation in receipt of physician advice on diet and exercise: applications of the behavioral model of health care utilization.
Am J Health Promot. 2004 May-Jun; 18(5):370-7.AJ

Abstract

PURPOSE

To identify factors associated with receipt of physician advice on diet and exercise, including patient sociodemographic characteristics, health-related needs, and health care access, using Andersen's model of health care utilization.

DESIGN

A cross-sectional analysis was performed using data from the 2000 National Health Interview Survey (NHIS).

SETTING

NHIS data were collected through personal household interviews by Census interviewers. The overall response rate for the 2000 NHIS adult sample was 82.6%.

SUBJECTS

Subjects were a representative sample of the American civilian, noninstitutionalized population aged 18 and older. After eliminating missing data and respondents who reported they did not see a doctor in the past 12 months, sample sizes for physician advice on diet and exercise were n = 26,255 and n = 26,158, respectively.

MEASURES

Using the 2000 NHIS, the prevalence of receipt of physician advice on diet and exercise was assessed. Multiple logistic regression analyses were performed to examine the associations between receipt of physician advice on diet and exercise and potential predictors, adjusting for all covariates.

RESULTS

By self-report, 21.3% and 24.5% of respondents received physician advice on diet and exercise, respectively. Being middle-aged (adjusted odds ratio [AOR] = 1.14, 95% confidence interval [CI], 1.0-1.29 for diet; AOR = 1.55, 95% CI = 1.33-1.79 for exercise) and having a baccalaureate degree or higher (AOR = 1.78, 95% CI = 1.52-2.08 for diet; AOR = 1.75, 95% CI = 1.47-2.07) were associated with a higher likelihood of receiving physician advice on diet and exercise. African-Americans (AOR = .78, 95% CI = .67-.92) and foreign-born immigrants (AOR = .57, 95% CI = .38-.86) were less likely to receive physician advice on exercise. The prevalence of physician advice was higher for persons who chose hospital outpatient departments as a usual source for care (AOR = 2.36, 95% CI = 1.66-3.36 for diet; AOR = 2.39, 95% CI = 1.68-3.4 for exercise) than for adults with other types of usual care sites. Poorer self-rated health status (AOR = 5.2, 95% CI = 4.12-6.57 for diet; AOR = 2.63, 95% CI = 2.04-3.38 for exercise) and obesity (AOR = 2.32, 95% CI = 2.02-2.66 for diet; AOR = 3.01, 95% CI = 2.46-3.69 for exercise) was positively associated with the likelihood of receiving physician advice on diet and exercise.

CONCLUSIONS

Effective strategies to increase receipt of physician advice should include efforts to improve access to regular source of care and patient-physician communication. Sociodemographic factors remain independent and important predictors of who obtains such advice.

Authors+Show Affiliations

Department of Epidemiology, Columbia University, New York City, New York 10034, USA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15163138

Citation

Honda, Keiko. "Factors Underlying Variation in Receipt of Physician Advice On Diet and Exercise: Applications of the Behavioral Model of Health Care Utilization." American Journal of Health Promotion : AJHP, vol. 18, no. 5, 2004, pp. 370-7.
Honda K. Factors underlying variation in receipt of physician advice on diet and exercise: applications of the behavioral model of health care utilization. Am J Health Promot. 2004;18(5):370-7.
Honda, K. (2004). Factors underlying variation in receipt of physician advice on diet and exercise: applications of the behavioral model of health care utilization. American Journal of Health Promotion : AJHP, 18(5), 370-7.
Honda K. Factors Underlying Variation in Receipt of Physician Advice On Diet and Exercise: Applications of the Behavioral Model of Health Care Utilization. Am J Health Promot. 2004 May-Jun;18(5):370-7. PubMed PMID: 15163138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors underlying variation in receipt of physician advice on diet and exercise: applications of the behavioral model of health care utilization. A1 - Honda,Keiko, PY - 2004/5/28/pubmed PY - 2004/7/2/medline PY - 2004/5/28/entrez SP - 370 EP - 7 JF - American journal of health promotion : AJHP JO - Am J Health Promot VL - 18 IS - 5 N2 - PURPOSE: To identify factors associated with receipt of physician advice on diet and exercise, including patient sociodemographic characteristics, health-related needs, and health care access, using Andersen's model of health care utilization. DESIGN: A cross-sectional analysis was performed using data from the 2000 National Health Interview Survey (NHIS). SETTING: NHIS data were collected through personal household interviews by Census interviewers. The overall response rate for the 2000 NHIS adult sample was 82.6%. SUBJECTS: Subjects were a representative sample of the American civilian, noninstitutionalized population aged 18 and older. After eliminating missing data and respondents who reported they did not see a doctor in the past 12 months, sample sizes for physician advice on diet and exercise were n = 26,255 and n = 26,158, respectively. MEASURES: Using the 2000 NHIS, the prevalence of receipt of physician advice on diet and exercise was assessed. Multiple logistic regression analyses were performed to examine the associations between receipt of physician advice on diet and exercise and potential predictors, adjusting for all covariates. RESULTS: By self-report, 21.3% and 24.5% of respondents received physician advice on diet and exercise, respectively. Being middle-aged (adjusted odds ratio [AOR] = 1.14, 95% confidence interval [CI], 1.0-1.29 for diet; AOR = 1.55, 95% CI = 1.33-1.79 for exercise) and having a baccalaureate degree or higher (AOR = 1.78, 95% CI = 1.52-2.08 for diet; AOR = 1.75, 95% CI = 1.47-2.07) were associated with a higher likelihood of receiving physician advice on diet and exercise. African-Americans (AOR = .78, 95% CI = .67-.92) and foreign-born immigrants (AOR = .57, 95% CI = .38-.86) were less likely to receive physician advice on exercise. The prevalence of physician advice was higher for persons who chose hospital outpatient departments as a usual source for care (AOR = 2.36, 95% CI = 1.66-3.36 for diet; AOR = 2.39, 95% CI = 1.68-3.4 for exercise) than for adults with other types of usual care sites. Poorer self-rated health status (AOR = 5.2, 95% CI = 4.12-6.57 for diet; AOR = 2.63, 95% CI = 2.04-3.38 for exercise) and obesity (AOR = 2.32, 95% CI = 2.02-2.66 for diet; AOR = 3.01, 95% CI = 2.46-3.69 for exercise) was positively associated with the likelihood of receiving physician advice on diet and exercise. CONCLUSIONS: Effective strategies to increase receipt of physician advice should include efforts to improve access to regular source of care and patient-physician communication. Sociodemographic factors remain independent and important predictors of who obtains such advice. SN - 0890-1171 UR - https://www.unboundmedicine.com/medline/citation/15163138/Factors_underlying_variation_in_receipt_of_physician_advice_on_diet_and_exercise:_applications_of_the_behavioral_model_of_health_care_utilization_ L2 - https://journals.sagepub.com/doi/10.4278/0890-1171-18.5.370?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -