The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64753

Marcia Ory, PhD¹, Paula Yuma, BS¹, Dhaval S. Patel, PhD¹, Ming Tai-Seale, PhD², Thomas Tai-Seale, DrPH³, Rachel Bramson, MD⁴, Richard Street, PhD⁵, David Hackethorn, MD⁶, Margo-Lea Hurwicz, PhD⁷, and Mary Ann Cook, PhD⁸. (1) School of Rural Public Health - Department of Social and Behavioral Health, Texas A & M University System Health Science Center, 3000 Briarcrest Drive, Suite 310, Bryan, TX 77802, (979) 845-2387, mory@srph.tamu.edu, (2) School of Rural Public Health - Department of Health Policy and Management, Texas A&M University System Health Science Center, MS 1266, College Station, TX 77843-1266, (3) School of Rural Public Health - Department of Social and Behavioral Health, Texas A&M University System Health Science Center, 3000 Briarcrest Drive, Suite 310, Bryan, TX 77802, (4) College of Medicine, Texas A&M University System Health Science Center, 154 Joe H Reynolds, Medical Building, College Station, TX 77843-1114, (5) Department of Speech Communication, Texas A&M University, 4324 TAMU, College Station, TX 77843-4234, (6) College of Medicine - Department of Internal Medicine, Texas A&M University System Health Science Center, 1600 University Drive, College Station, TX 77840, (7) Department of Anthropology and Gerontology, University of Missouri - St. Louis, 8001 Natural Bridge Road, St. Louis, MO 63121-4499, (8) JVC Radiology and Medical Analysis LLC, 6319 Alexander Drive, Clayton, MO 63105

There is growing consensus that physician recommendations can be key to patient initiation of health promoting behaviors. Yet, other than the infrequency of such discussions, little is known about the extent of physician’s lifestyle counseling. This paper investigates the frequency of discussions about exercise, nutrition, and smoking during visits with older patients, and the impact of the length of the visit, reason for visit (acute vs. non-acute), physician supportiveness, and length of relationship on the likelihood that discussions will occur. Data from videotaped 446 visits between patients 65 and older and primary care providers in three health care settings was analyzed. The patient sample is two-thirds female and 25% minority. Exercise is mentioned in about 40% of the visits, nutrition in 48% and smoking in 14%. Although longer visits are more likely to include discussions of exercise and nutrition, over one-third of the visits containing these discussions are less than 10 minutes long. Exercise and nutrition are more likely to be discussed during non-acute visits, while smoking is not affected by the reason for visit. Supportive physicians are more likely to discuss exercise, nutrition, and smoking, and longer patient-physician relationships are associated with exercise conversation. Implications for practice include a need to educate and train physicians to address lifestyle issues with older patients during visits. It may also be beneficial to educate older patients about discussing lifestyles during medical visits.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to: (
• Discuss the extent to which physicians discuss lifestyle issues with their older patients, (
• Recognize how visit characteristics can impact the likelihood of lifestyle discussions in medical visits with older patients, and (
• Identify 3 ways to initiate and/or improve lifestyle discussions in primary care visits with older patients.

Keywords: Health Communications, Elderly

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.