Healthy and Fit for Prevention: The Influence of Clinician Health and Fitness on Promotion of Healthy Lifestyles During Health Supervision Visits

Abstract

To understand the relationship between pediatricians' personal health and the delivery of pediatric preventive care, Illinois pediatricians were surveyed by mail. Responses from 387 pediatricians (55% response rate) regarding personal characteristics, their practice, and perceptions about preventive care patterns for children aged 2 through 10 years and management of overweight children were analyzed. Overall, 28% of pediatricians were healthy and fit (excellent/very good health and extremely/ very fit), 40% were either healthy or fit, and 33% were neither healthy nor fit. In logistic regression models controlling for personal and practice characteristics, healthy and fit pediatricians (vs neither healthy nor fit pediatricians) more routinely provided recommended care on child diet (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.6-6.2) and physical activity (OR, 3.2; 95% CI, 1.6-6.3) and assessed television time (OR, 4.4; 95% CI, 2.0-10.1). Pediatricians who were either healthy or fit (vs pediatricians who were neither healthy nor fit) more often assessed television time. Therefore, clinician health influenced application of preventive care.

Keywords

pediatrician children prevention fitness health care research counseling

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References

Green M , Palfrey JS , eds. Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents. 2nd ed. Arlington, Va: National Center for Education in Maternal and Child Health; 2002.

American Academy of Pediatrics. Guidelines for Health Supervision III. 3rd ed. Elk Grove, Ill: American Academy of Pediatrics; 1997.

American Academy of Pediatrics Committee on Nutrition. Prevention of pediatric overweight and obesity . Pediatrics. 2003;112:424-430.

Galuska DA , Fulton JE , Powell EK , et al. Pediatrician counseling about preventive health topics: results from the Physicians' Practices Survey, 1998-1999. Pediatrics . 2002;109:e83.

Yarnall Ksh , Pollak KI , stbye T. , Krause KM , Michener JL

Primary care: is there enough time for prevention?

Am J Public Health. 2003;93:635-641.

Green LW , Eriksen MP , Schor EL Preventive practices by physicians: behavioral determinants and potential intervention. Am J Prev Med. 1988;4(suppl):101-107.

Lawrence RS Diffusion of the U.S. Preventive Services Task Force recommendations into practice. J Gen Intern Med. 1990;5(suppl):S99-S103.

Bandura A. Principles of Behavior Modification. New York, NY: Holt, Rinehart & Winston; 1969:118-167.

Golan M. , Weizman A. Familial approach to the treatment of childhood obesity: conceptual model . J Nutr Educ. 2001;33:102-107.

10.

Hash RB , Munna RK , Vogel RL , Bason JJ

Does physician weight affect perception of health advice?

Prev Med. 2003;36:41-44.

11.

Heath J. , Andrews J. , Kelley FJ , Sorrell J. Caught in the middle: experiences of tobacco-dependent nurse practitioners . J Am Acad Nurse Pract. 2004;16:396-401.

12.

Kawakami M. , Nakamura S. , Fumimoto H. , Takizawa J. , Baba M. Relation between smoking status of physicians and their enthusiasm to offer smoking cessation advice. Intern Med. 1997;36:162-165.

13.

Willaing I. , Jorgensen T. , Iversen L.

How does individual smoking behaviour among hospital staff influence their knowledge of the health consequences of smoking? Scand

J Public Health. 2003;31:149-155.

14.

Ohida T. , Sakurai H. , Mochizuki Y. , et al. Smoking prevalence and attitudes toward smoking among Japanese physicians. JAMA. 2001;285:2643-2648.

15.

Nelson DE , Giovino GA , Emont SL , et al. Trends in cigarette smoking among US physicians and nurses. JAMA. 1994;271:1273-1275.

16.

Trowbridge FL , Sofka D. , Holt K. , Barlow SE Management of child and adolescent obesity: study design and practitioner characteristics. Pediatrics . 2002;110(pt 2): 205-209.

17.

Kolagotla L. , Adams W. Ambulatory management of childhood obesity . Obesity Res. 2004;12:275-283.

18.

Story MT , Neumark-Stzainer DR , Sherwood NE , et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002:110(pt 2);210-214.

19.

Jonides L. , Buschbacher V. , Barlow SE Management of child and adolescent obesity: psychological, emotional, and behavioral assessment. Pediatrics. 2002;110 (pt 2): 215-221.

20.

Barlow SE , Dietz WH , Klish WJ , Trowbridge FL Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians. Pediatrics. 2002;110(pt 2): 222-228.

21.

Hosmer DW , Lemeshow S. Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989:135-175.

22.

Abramson S. , Stein J. , Schaufele M. , Frates E. , Rogan S. Personal exercise habits and counseling practices of primary care physicians: a national survey. Clin J Sport Med. 2000;10:40-48.

23.

Rosenstock IM , Strecher VJ , Becker MH Social learning theory and the Health Belief Model. Health Educ Q. 1988;15:175-183.

24.

Perrin EM , Flower KB , Garrett J. , Ammerman AS

Preventing and treating obesity: pediatricians' self-efficacy, barriers, resources, and advocacy. Ambul

Pediatr. 2005; 5:150-156.