Evaluation of Internal Medicine Residents as Exercise Role Models and Associations With Self-Reported Counseling Behavior, Confidence, and Perceived Success
ABSTRACT Patients perceive physicians who practice healthy personal behaviors as more credible and better able to motivate patients to make healthy lifestyle choices.
To evaluate internal medicine resident physicians as role models for promoting exercise by an assessment of physician physical activity behavior, cardiovascular fitness, physical activity knowledge, personal use of behavior modification techniques, attitudes toward personal physical activity practice, and confidence (i.e., self-efficacy) in the knowledge and personal utilization of behavior modification techniques and to explore the associations with self-reported patient counseling behavior, confidence, and perceived success.
Cross-sectional study of internal medicine resident physicians with a self-administered survey, treadmill fitness testing, and a 7-day physical activity recall.
Fifty-one resident physicians agreed to participate (response rate = 81%). Fitness levels were below average for 60%, average for 25%, and above average or excellent for 15%. The mean energy expenditure was 234 kcal/kg/week, with 41% of physicians meeting recommended physical activity guidelines. Few reported high self-efficacy (33%) or perceived success (25%) in the ability to be regularly active. Few demonstrated adequate knowledge useful for patient counseling (e.g., listing 3 ways to integrate physical activity into daily life [27%], calculating target heart rate [29%], and identifying personal exercise stages of change [25%]). Personal use of behavior modification techniques was reported infrequently. Although 88% reported confidence in the knowledge of exercise benefits, less than half reported confidence in the knowledge of local facilities, American College of Sports Medicine (ACSM) guidelines, and behavior modification techniques. Multiple linear regression demonstrated that a higher level of training (p = .02) and a greater confidence in the knowledge of ACSM guidelines (p = .048, total R2 = .21) independently predicted more frequent self-reported counseling. Sex (i.e., male; p = .01) and greater physical activity self-efficacy (p = .017, total R2 = .23) independently predicted greater perceived counseling success. Greater physical activity enjoyment (p = .03) and greater perceived success at engaging in regular physical activity (p = .028, total R2 = .28) independently predicted greater counseling self-efficacy.
Most internal medicine resident physicians may not be adequate role models for promoting exercise adherence. Confidence in the knowledge of current guidelines, personal physical activity enjoyment, and perceived success and self-efficacy in engaging in regular physical activity may be useful targets for enhancing resident physician physical activity counseling for their patients.
- SourceAvailable from: Ahmed J Romain
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- "To improve the involvement of GPs in managing obesity through promoting PA in the community, the present study aimed to assess their attitudes and practices when evaluating and prescribing PA. As the health and habits of healthcare professionals have been demonstrated to influence their attitudes towards PA promotion, reflected by the fact that unfit health professionals are less optimistic about promoting PA than physically fit professionals     , the relationship between GPs' personal characteristics, including their weight, PA status and attitudes towards promoting PA for weight management, were examined. "
ABSTRACT: The study documented the attitudes and practices of French general practitioners (GPs) regarding the prescription of physical activity (PA) for obesity management. A cross-sectional survey of all 254GPs with practices in a city in the south of France was performed, of which 203 (80%) questionnaires were returned. From these, demographic, professional and personal data, beliefs, attitudes, training and barriers to prescribing PA were assessed. GPs are very much aware of the importance of PA in the management of obesity, as 94% reportedly prescribed it frequently ('usually' or 'often'). However, only a minority recommended PA levels that were consistent with most guidelines. Even though most of the GPs (71%) reported a lack of training in prescribing PA, only a slight majority (52%) wished to undergo such training. Patients' non-compliance was the main obstacle for 63% of the GPs. Also, although only 1% of the GPs used software and Internet resources, 62% expressed a desire to incorporate these tools in their practices. The personal characteristics of GPs also influenced their attitudes and practices, as reflected by the fact that overweight or obese GPs favoured psychobehavioural management rather than PA (P=0.03). Younger GPs (<45 years) felt less adequately trained than their elders (P=0.01) and were more eager for additional training. GPs play a central role in preventing the pandemic of obesity and other chronic diseases for which PA is a cornerstone. However, the need to improve GP practices in prescribing PA remains a challenge. Better medical education and the development of adequate Web-based tools should also be prioritized.Diabetes & Metabolism 02/2012; 38(3):243-9. DOI:10.1016/j.diabet.2011.12.004 · 2.85 Impact Factor
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- "McDermott et al. (2002) demonstrated that attitudes toward the importance and effectiveness of risk factor interventions influenced whether healthcare providers initiated CVD risk factor reduction education with patients. Patients' observations and perceptions of the healthcare provider's attitudes , behaviors while interacting, and personal health-related lifestyle influence patients' confidence in their provider and their receptivity to CVD risk prevention education (Geirsson, Bendtsen, & Spak, 2005; McFall, Nonneman, Rogers, & Mukerji, 2009; Rogers et al., 2006). Despite the increasing morbidity and mortality due to CVD in China and the potential for nurses to be instrumental in providing education to help reduce this threat, no published study was found reporting Chinese nurses' knowledge, attitudes, practices, and personal behaviors related to CVD risk reduction. "
ABSTRACT: The rising incidence of cardiovascular disease (CVD) in China intensifies the need for effective health education for CVD risk reduction. The purpose of this study was to develop a description of nurses' knowledge about, attitudes toward, practice behaviors, and personal lifestyle behaviors related to CVD risk reduction. We surveyed 273 staff nurses, 35 nursing faculty, and 139 nursing students in Beijing. Most nurses could identify common risk factors for CVD and had positive attitudes toward CVD risk reduction. However, less than 58% of the respondents could correctly answer questions about evidence-based recommendations for CVD risk reduction. This sample of Chinese nursing professionals and students lacked knowledge critical to providing guidance to individuals with or at risk for CVD. More intensive and creative approaches to the education of nursing professionals regarding CVD risk reduction are recommended.Research in Nursing & Health 06/2011; 34(3):228-40. DOI:10.1002/nur.20431 · 1.16 Impact Factor