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Rebecca M. Hirschhorn, Cassidy Holland, Amy F. Hand, and James M. Mensch

Key Points ▸ Physicians have more positive perceptions of athletic trainers’ skills than previous research has indicated. ▸ Organization and administration continues to be a perceived weakness among the athletic training domains. ▸ Experience working with an athletic trainer did not significantly

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Ronald D. Adelman, Michele G. Greene, Erika Friedmann, Marcia G. Ory, and Caitlin E. Snow

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.

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Maura Reilly, Guadalupe X. Ayala, John P. Elder, and Kevin Patrick

Background:

Research suggests that individuals who talk with their physicians about lifestyle behaviors are more physically active. Research on this topic is limited in the U.S. Latino population. This study examines doctor-patient communication from the perspective of enrollees in a physical activity (PA) intervention.

Methods:

Three hundred and eighty-seven Latinos were surveyed at program enrollment. Analysis examined the extent to which physician communication about healthy lifestyles and weight was associated with self-reported PA, including leisure-time PA (LTPA), transportation PA (TPA), and occupational PA (OPA). Physician communication included asking, advising, and assisting.

Results:

Most of the respondents reported no LTPA (46%) and no TPA (60%). The percent reporting no occupational activity, which included housework if a homemaker, was lower at 36%. Greater physician assistance was associated with a greater likelihood of doing any LTPA (P ≤ .05). A similar trend was observed for TPA (P ≤ .10).

Conclusions:

Latinos who reported physician assistance to engage in healthy lifestyle behaviors reported more LTPA. Providers who assist their patients in obtaining resources to support PA have the potential to increase levels of PA.

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Gina M. Besenyi, Emi B. Hayashi, and Richard W. Christiana

, such as physicians or nurse practitioners, thus impacting the success of PA counseling programs. 62 Indeed, one review found that allied HCPs saw greater long-term PA behavior change success as a result of PA counseling compared with physician only interventions. 62 A meta-analysis of physiotherapist

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Bradley J. Cardinal, Eugene A. Park, MooSong Kim, and Marita K. Cardinal

Background:

This study provides an update on the amount and type of physical activity education occurring in medical education in the United States in 2013. It is the first study to do so since 2002.

Methods:

Applying content analysis methodology, we reviewed all accessible accredited doctor of medicine and doctor of osteopathic medicine institutions’ websites for physical activity education related coursework (N = 118 fully accessible; 69.41%).

Results:

The majority of institutions did not offer any physical activity education–related courses. When offered, they were rarely required. Courses addressing sports medicine and exercise physiology were offered more than courses in other content domains. Most courses were taught using a clinical approach. No differences were observed between MD and DO institutions, or between private and public institutions.

Conclusions:

More than one-half of the physicians trained in the United States in 2013 received no formal education in physical activity and may, therefore, be ill-prepared to assist their patients in a manner consistent with Healthy People 2020, the National Physical Activity Plan, or the Exercise is Medicine initiative. The Bipartisan Policy Center, American College of Sports Medicine, and the Alliance for a Healthier Generation called for a reversal of this situation on June 23, 2014.

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Alseny Balde, Jaime Figueras, Dawn A. Hawking, and John R. Miller

Lack of physical activity is an increasing public-health problem. Physicians should counsel elderly patients to maintain regular physical activity in order to retain functionality and quality of life. This study examined the patterns of physician advice about physical activity in an elderly population. A homogeneous group of older adults living in public housing (N = 146) was surveyed to determine the extent to which they received such advice. Their mean age was 77.9 ± 7 years, 74% were women, 70.5% were White, and 53.4% had high school education or less. We assessed the association between physician counseling practices and the participants’ demographic characteristics, overweight status, and type of physical activity performed. The prevalence rate of physician counseling was 61.6%. Elderly men who were married and those who were overweight were most likely to receive advice. Routine physician counseling of elderly patients regardless of overweight status could contribute to improving their quality of life.

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Column-editor : Tracy Ray

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José Emilio Jiménez-Beatty Navarro, José Luis Graupera Sanz, Jesus Martínez del Castillo, Antonio Campos Izquierdo, and María Martín Rodríguez

This study aimed to ascertain by means of a new scale older adults’ motives for engaging in physical activity, in a probability and representative sample of an older urban population. The sample size was 630 older adults, ranging from 65 to 94 years in age, randomly selected using multistage sampling. The participants completed a 17-item questionnaire, as well as answering questions on demographic variables, type of demand for physical activity, and physician’s recommendation. A principal-component analysis was performed. The relationships among the four factors (physical health, social relationships, competence, and physician’s advice) show a clearly motivational structure. Significant relationships have also been found between physician’s recommendation and type of demand. The findings suggest that programs promoting physical activity in older adults should have different characteristics from those aimed at general adult populations.

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Alba Pardo, Jim McKenna, Anna Mitjans, Berenguer Camps, Silvia Aranda-Garcia, Juanjo Garcia-Gil, and Mariona Violan

Background:

Physicians’ own Physical Activity (PA) and other health-related habits influence PA promotion. The current study identifies the PA level, according to the current PA recommendations and other health-related habits of physicians from the Catalan Medical Council.

Methods:

2400 physicians (30–55 years) were randomly selected; each received a self-administered mailed questionnaire identifying medical specialization, work setting, health self-perception, body mass index (BMI), PA, and smoking habits.

Results:

762 physicians responded (52% female). Almost 1 in 2 (49.3%) exercised sufficiently, nearly all selfperceived good health, while 80.5% were nonsmokers. Almost 6 in 10 males reported overweight or obesity (56.9%) versus 18.2% of females. Active physicians dominated specific groups: (1) aged 45–55 years, (2) specializing either in primary care or surgery, (3) working in the private sector, (4) BMI < 25kg/m2, (5) perceiving themselves in good health, or (6) having free leisure time.

Conclusions:

Only half of Catalan physicians met current PA recommendations; male physicians were particularly at risk for overweight/obesity. Overweight and under-exercise were associated with private workplaces and positive health perceptions, meaning that it is it is now possible to target inactive and/or overweight Catalan physicians in future interventions.

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Fabio A. Almeida, Renae L. Smith-Ray, Rain Van Den Berg, Patti Schriener, Mike Gonzales, Pierre Onda, and Paul A. Estabrooks

Within the busy clinic visit and multiple preventive guidelines to follow, the rate of physician referral for physical activity (PA) is disappointing. This study used an interrupted time-series design to determine the effect of a simple stimulus control strategy to increase physician referrals for PA when compared to standard care before and after exposure to the stimulus control intervention. The number of referrals (N = 218 total) per week was significantly higher during weeks when the stimulus control intervention was used (p < .01). Approximately 77% of participants referred during standard care weeks initiated a PA program while 67% of those referred during stimulus control weeks initiated PA. These rate differences were significant (p < .05). Nonetheless, the number of individuals who initiated PA was greater during stimulus control weeks than during usual care weeks (p < .05; 9.8 vs. 5.6), due to the larger total volume of referrals. We concluded that stimulus control interventions targeting physician referrals are a practical method for enhancing participation in PA programs.