Race, gender, and lifestyle discussions in geriatric primary care medical visits
B. Mitchell Peck, Margo-Lea Hurwicz, Marcia Ory, Paula Yuma, Mary Ann Cook
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DOI: 10.4236/health.2010.210168   PDF    HTML     4,577 Downloads   8,423 Views   Citations

Abstract

Increasingly, healthcare providers are required to spend more time and effort aimed at prevention and lifestyle modification. Many argue that providers are in a unique position to provide information for effective lifestyle and behavior change. Yet, relatively little is known about how in- terpersonal provider and patient characteristics, such as race and gender, affect discussions of lifestyle choices about public health issues. To understand better how patient and physician characteristics influence discussions of lifestyle behaviors, we conducted a prospective, cohort study of interactions between primary care physicians and their geriatric patients. We videotaped 381 elderly patient visits with 35 primary care physicians. We coded the encounters to indicate whether the patient and physician discussed lifestyle issues around nutrition, physical activity, and smoking. The independent variables were patient and physician race, gender, and concordant status. Discussions about nutrition were the most common lifestyle topic (47.8%), followed by physical activity (40.3%) and smoking (14.2%). Multivariate analysis indicate white patients are significantly less likely to have discussions with their physicians about nutrition (OR = 0.32, p = 0.02) and same gender encounters are also less likely to discuss diet/nutrition (OR = 0.59, p = 0.04). There were no significant differences for discussions about physical activity or smoking. Previous research has shown that differences persist in the quality of care and certain outcomes. Our results suggest these differrences are not exclusively the result of differences in the prevalence of lifestyle discussions based on patient and physician race or gender.

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Peck, B. , Hurwicz, M. , Ory, M. , Yuma, P. and Cook, M. (2010) Race, gender, and lifestyle discussions in geriatric primary care medical visits. Health, 2, 1150-1155. doi: 10.4236/health.2010.210168.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Heron, M. (2010) Deaths: Leading causes for 2006. National Vital Statistics Reports, 58, National Center for Vital Statistics, Hyattsville.
[2] Mokdad, A.H., et al. (2004) Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291(10), 1238-1245.
[3] Day, J.C. (2006) Projections of the number of housholds and families in the United States: 1995 to 2010, U.S. Bureau of the Census, Current Population Reports, P25-1129. U.S. Government Printing Office, Washington, DC.
[4] Beaudoin, C., et al. (2001) Discussion of lifestyle-related issues in family practice during visits with general medical examination as the main reason for encounter: an exploratory study of content and determinants. Patient Education and Counseling, 45(4), 275-284.
[5] Nutting, P.A. (1986) Health promotion in primary medical care: Problems and potential. Preventive Medicine, 15(5), 537-548.
[6] Stott, N.C. (1986) The role of health promotion in primary health care. Health Promotion, 1(1), 49-53.
[7] Glasgow, R.E., et al. (2001) Physician advice and support for physical activity: Results from a national survey. American Journal of Preventive Medicine, 21(3), 189- 196.
[8] Wiggers, J.H. and Sanson-Fisher, R. (1994) General practitioners as agents of health risk behavior change: Opportunities for behavioral science in patient smoking cessation. Behaviour Change, 11(2), 167-176.
[9] Institute of Medicine (1999) The role of nutrition in maintaining health in the nation’s elderly: Evaluating coverage of nutrition services for the medicare population. National Academy Press, Washington, DC.
[10] Ware Jr., J.E. and Sherbourne, C.D. (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473-483.
[11] Cook, M.A. (2002) Final report: Assessment of doctor-elderly patient encounters. National Institute on Aging, Washington, DC.
[12] Huber, P.J. (1967) The behavior of maximum likelihood estimates under nonstandard conditions. Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability, Volume 1: Statistics, 1(1), 221-233.
[13] White, H. (1980) A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica, 48(4), 817-830.
[14] Roter, D.L. and Hall, J.A. (2004) Physician gender and patient-centered communication: a critical review of empirical research. Annual Review of Public Health, 25(1), 497-519.
[15] Epstein, A.M., et al. (2003) Race and gender disparities in rates of cardiac revascularization: do they reflect appropriate use of procedures or problems in quality of care? Medical Care, 41(11), 1240-1255.
[16] Institute of Medicine (2002) Unequal treatment: confronting racial and ethnic disparities in health care. National Academy Press, Washington, DC.
[17] Cooper-Patrick, L., et al. (1999) Race, gender, and partnership in the patient-physician relationship. Journal of the American Medical Association, 282(6), 583-589.

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