This cross-sectional observational study examined the frequency of older patient–physician discussions about exercise, who initiates discussions, and the quality of questioning, informing, and support about exercise. The study used a convenience sample of 396 follow-up visits at 3 community-based practice sites, with 376 community-dwelling older patients and 43 primary-care physicians. Audiotapes were analyzed using the Multi-Dimensional Interaction Analysis coding system. Results demonstrate that exercise was discussed in 13% of visits and the subject was raised equally by patients and physicians. Exercise was significantly more likely to be discussed in dyadic visits (14.7%) than in triadic visits (4.1%). Patient level of education, patient overall physical health, and the physician’s being female were significant predictors of the occurrence of exercise discussion. Given the importance of exercise for maintaining health and independence in older adults, more clinical and research attention is needed to address barriers to effective discussions in this area.
Adelman and Snow are with the Div. of Geriatrics and Gerontology, Weill Medical College of Cornell University, New York, NY. Greene is with the Dept. of Health and Nutrition Sciences, Brooklyn College, Brooklyn, NY. Friedmann is with the School of Nursing, University of Maryland, Baltimore, MD. Ory is with the Dept. of Social and Behavioral Health, Texas A&M Health Science Center, College Station, TX.