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Diet and physical activity counseling during ambulatory care visits in the United States.

Abstract

BACKGROUND

Research is limited regarding national patterns of behavioral counseling during ambulatory care. We examined time trends and independent correlates of diet and physical activity counseling for American adults with an elevated cardiovascular risk during their outpatient visits.

METHODS

The National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) provided 1992-2000 national estimates of counseling practices in private physician offices and hospital outpatient departments.

RESULTS

Rates of diet and physical activity counseling among visits by at-risk adults exhibited a modest ascending trend from 1992 to 2000, with the biggest growth found between 1996 and 1997. Throughout the 1990s, however, diet counseling was provided in <45% and physical activity counseling in < or = 30% of visits by adults with hyperlipidemia, hypertension, obesity, or diabetes mellitus. Lower likelihood of either counseling was significantly associated with patients who were > or = 75 years of age, seen by generalists, and those with fewer risk factors. Also, diet counseling was less frequently provided during visits by whites vs. ethnic minorities and by men vs. women.

CONCLUSIONS

Despite available national guidelines, diet and physical activity counseling remain below expectations during outpatient visits by adults with an elevated cardiovascular risk. Given recent trends, immediate, satisfactory improvement is unlikely without future innovative interventions.

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  • Authors+Show Affiliations

    ,

    Program of Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University, CA 94305-5705, USA.

    , ,

    Source

    Preventive medicine 39:4 2004 Oct pg 815-22

    MeSH

    Adult
    Aged
    Ambulatory Care
    Cardiovascular Diseases
    Counseling
    Diabetes Mellitus
    Diet
    Exercise
    Female
    Humans
    Hyperlipidemias
    Hypertension
    Male
    Middle Aged
    Obesity
    Outpatients
    Risk Factors
    Surveys and Questionnaires
    Time Factors
    United States

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    15351551

    Citation

    Ma, Jun, et al. "Diet and Physical Activity Counseling During Ambulatory Care Visits in the United States." Preventive Medicine, vol. 39, no. 4, 2004, pp. 815-22.
    Ma J, Urizar GG, Alehegn T, et al. Diet and physical activity counseling during ambulatory care visits in the United States. Prev Med. 2004;39(4):815-22.
    Ma, J., Urizar, G. G., Alehegn, T., & Stafford, R. S. (2004). Diet and physical activity counseling during ambulatory care visits in the United States. Preventive Medicine, 39(4), pp. 815-22.
    Ma J, et al. Diet and Physical Activity Counseling During Ambulatory Care Visits in the United States. Prev Med. 2004;39(4):815-22. PubMed PMID: 15351551.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diet and physical activity counseling during ambulatory care visits in the United States. AU - Ma,Jun, AU - Urizar,Guido G,Jr AU - Alehegn,Tseday, AU - Stafford,Randall S, PY - 2004/9/8/pubmed PY - 2005/4/19/medline PY - 2004/9/8/entrez SP - 815 EP - 22 JF - Preventive medicine JO - Prev Med VL - 39 IS - 4 N2 - BACKGROUND: Research is limited regarding national patterns of behavioral counseling during ambulatory care. We examined time trends and independent correlates of diet and physical activity counseling for American adults with an elevated cardiovascular risk during their outpatient visits. METHODS: The National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) provided 1992-2000 national estimates of counseling practices in private physician offices and hospital outpatient departments. RESULTS: Rates of diet and physical activity counseling among visits by at-risk adults exhibited a modest ascending trend from 1992 to 2000, with the biggest growth found between 1996 and 1997. Throughout the 1990s, however, diet counseling was provided in <45% and physical activity counseling in < or = 30% of visits by adults with hyperlipidemia, hypertension, obesity, or diabetes mellitus. Lower likelihood of either counseling was significantly associated with patients who were > or = 75 years of age, seen by generalists, and those with fewer risk factors. Also, diet counseling was less frequently provided during visits by whites vs. ethnic minorities and by men vs. women. CONCLUSIONS: Despite available national guidelines, diet and physical activity counseling remain below expectations during outpatient visits by adults with an elevated cardiovascular risk. Given recent trends, immediate, satisfactory improvement is unlikely without future innovative interventions. SN - 0091-7435 UR - https://www.unboundmedicine.com/medline/citation/15351551/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091743504001641 DB - PRIME DP - Unbound Medicine ER -