Online Program

328985
Health care providers' recommendations for physical activity and individuals' adherence: Racial/ethnic disparities among U.S. arthritis population


Monday, November 2, 2015

Shamly Austin, PhD, MHA, Research and Development, Quality Improvement Department, Gateway Health, Pittsburgh, PA
Maria Pisu, PhD, Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Haiyan Qu, PhD, Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Richard Shewchuk, PhD, Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Introduction: Minorities receive poor quality of care even when access-related factors, such as insurance status and income are controlled. We examined racial/ethnic disparities in health care providers’ recommendations for physical activity and determined the association between individuals’ race/ethnicity and adherence to physical activity guidelines among those who received recommendations.

Methods: With a cross-sectional design based on 2011 and 2013 Behavioral Risk Factor Surveillance System data from 16 U.S. states, analyzed  individuals with physician-diagnosed arthritis, ≥ 45 years old (n=26,186).  Outcome variables (dichotomous) were healthcare providers’ recommendations and individuals’ adherence to physical activity guidelines. Racial/ethnic groups were African-American, Hispanic, and whites (reference group). We used a three-level (individual, interpersonal, environmental) psychosocial framework to ensure all relevant covariates are considered. Individual-level factors were age, race, gender, health coverage, body mass index, health status, pain, and co-morbidities. Interpersonal-level factors were marital status and usual source of care. Environmental-level factors were education, employment, income, and U.S region. Associations were examined in two weighted multivariate logistic regression models.

 Results: African-Americans and Hispanics were more likely (p<.05) to receive providers’ recommendations for physical activity compared to whites. However, in a subset of individuals who received providers’ recommendations, African-Americans were less likely to adhere to guidelines (p< .05) and for Hispanics the association was not significant.

 Conclusion: Few studies in arthritis have analyzed racial/ethnic disparities in providers’ recommendations for physical activity.  Our study’s three broad findings include poor quality of care and reverse racial/ethnic disparity, lack of cultural competency among providers, and need for patient literacy on physical activity in arthritis population.

Learning Areas:

Advocacy for health and health education
Chronic disease management and prevention
Diversity and culture
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Analyze whether racial ethnic disparities exist in health care providers’ recommendations for physical activity in arthritis population. Examine whether individuals who received health care providers’ recommendations were likely to adhere to physical activity guidelines. Identify characteristics of individuals who adhere to physical activity guidelines among individuals who received health care providers’ recommendations.

Keyword(s): Health Promotion and Education, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health services researcher with experience in the area of arthritis and physical activity. My research seeks to address the challenges in quality of health care, access, and outcomes. My previous work in arthritis population include age bias in providers’ recommendation for physical activity, adherence to physical activity and HRQOL, providers’ recommendation for physical activity and adherence to physical activity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.