Ahmed Nasar U, Delgado Michael, Saxena Anshul
Department of Epidemiology, Florida International University, United States.
Department of Epidemiology, Florida International University, United States.
Prev Med. 2017 Jun;99:1-6. doi: 10.1016/j.ypmed.2017.01.015. Epub 2017 Feb 2.
Recognizing the undisputed health benefits of exercise, physicians' counseling has been included in the Healthy People Objectives since 2000. To address the paucity of data on such counseling at the national level, we examined changing trends and disparities in receiving physicians' counseling on exercise among the physically-able, non-institutionalized U.S. adult population. Data from the 2000, 2005, and 2010 National Health Interview Surveys (NHIS) were examined using logistic regression that included race/ethnicity, age, gender, education, insurance status, number of physician visits in the past year, and body mass index. In 2000, only 22.9% of NIHS respondents had received counseling on exercise, increasing to 33.6% in 2010. Compared with non-Hispanic Whites, non-Hispanic Blacks were 27% less likely to receive exercise advice in 2000 (adjusted odds ratio [AOR] 0.73, 95% confidence interval [CI] 0.61-0.87). In later years, they were equally likely to receive advice. Although decreased over the years, male respondents were significantly (34% to 23%) less likely to report receipt of exercise counseling than female patients (in 2010: AOR 0.77, CI 0.72-0.83). Uninsured respondents were 35% less likely to report receiving exercise advice from their provider in all study years (2010: AOR 0.64, CI 0.59-0.72). Patients with increasing levels of education were increasingly more likely to report receipt of counseling in each successive survey year. The overall prevalence of physicians' counseling on exercise increased moderately between 2000 and 2010. Some disparities narrowed and even reversed but significant disparities continue to exist across gender, insurance status, and education level.
认识到运动对健康有着无可争议的益处,自2000年起,医生提供的运动咨询就被纳入了“健康人民目标”之中。为了填补国家层面此类咨询数据的空白,我们研究了美国有身体活动能力、非机构化成年人群中接受医生运动咨询的趋势变化及差异。我们使用逻辑回归分析了2000年、2005年和2010年全国健康访谈调查(NHIS)的数据,该分析纳入了种族/族裔、年龄、性别、教育程度、保险状况、过去一年的就诊次数以及体重指数等因素。2000年,只有22.9%的NHIS受访者接受过运动咨询,到2010年这一比例增至33.6%。与非西班牙裔白人相比,2000年非西班牙裔黑人接受运动建议的可能性要低27%(调整后的优势比[AOR]为0.73,95%置信区间[CI]为0.61 - 0.87)。在随后几年中,他们接受建议的可能性相同。尽管多年来有所下降,但男性受访者报告接受运动咨询的可能性仍显著低于女性患者(2010年:AOR为0.77,CI为0.72 - 0.83),从34%降至23%。在所有研究年份中,未参保受访者报告从其医疗服务提供者处获得运动建议的可能性要低35%(2010年:AOR为0.64,CI为0.59 - 0.72)。在连续的每个调查年份中,受教育程度不断提高的患者报告接受咨询的可能性越来越大。2000年至2010年间,医生提供运动咨询的总体患病率适度上升。一些差异缩小甚至逆转,但在性别、保险状况和教育水平方面仍存在显著差异。