Sreedhara Meera, Silfee Valerie J, Rosal Milagros C, Waring Molly E, Lemon Stephenie C
Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Fam Pract. 2018 Jul 23;35(4):420-425. doi: 10.1093/fampra/cmx140.
Regular physical activity (PA) lowers the risk of cardiovascular disease (CVD), but few US adults meet PA guidelines. The United States Preventive Services Task Force (USPSTF) recommends primary care providers offer PA counselling for CVD prevention. We examined the association between adherence to PA guidelines and reported provider advice to increase PA among US adults with overweight/obesity and ≥1 additional CVD risk factor.
Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) on PA and provider advice to increase PA were analysed for 4158 adults (≥20 years old) with overweight/obesity who reported ≥1 of hypertension, high cholesterol or impaired fasting glucose. Adherence to federal PA guidelines was determined using self-reported PA data from the Global Physical Activity Questionnaire. Meeting PA guidelines was defined as ≥150 minutes/week moderate intensity PA, ≥75 minutes/week vigorous intensity, or an equivalent combination. Participants self-reported provider advice to increase PA.
In total, 57.7% of US adults with overweight/obesity and ≥1 additional CVD risk factor who did not meet PA guidelines reported provider advice to increase PA compared to 49.7% of adults who met PA guidelines. Adults who did not meet PA guidelines were more likely to report provider PA advice (aOR = 1.21; 95% CI = 1.00-1.47).
US adults with CVD risk factors who do not meet PA guidelines are more likely to receive provider advice to increase PA, but only half receive such advice. Strategies to increase provider advice are needed to improve adherence to USPSTF guidelines among US adults with overweight/obesity and additional CVD risk factors.
规律的体育活动（PA）可降低心血管疾病（CVD）风险，但很少有美国成年人达到PA指南的要求。美国预防服务工作组（USPSTF）建议初级保健提供者提供PA咨询以预防CVD。我们研究了超重/肥胖且至少有一项其他CVD风险因素的美国成年人中，PA指南的依从性与报告的提供者关于增加PA的建议之间的关联。
分析了来自国家健康和营养检查调查（2011 - 2014年）的横断面数据，这些数据涉及4158名超重/肥胖（≥20岁）且报告有高血压、高胆固醇或空腹血糖受损中至少一项的成年人的PA情况以及提供者关于增加PA的建议。使用全球身体活动问卷中自我报告的PA数据来确定对联邦PA指南的依从性。达到PA指南定义为每周至少150分钟中等强度PA、每周至少75分钟高强度PA或等效组合。参与者自我报告提供者关于增加PA的建议。
在超重/肥胖且至少有一项其他CVD风险因素但未达到PA指南的美国成年人中，共有57.7%报告了提供者关于增加PA的建议，而达到PA指南的成年人这一比例为49.7%。未达到PA指南的成年人更有可能报告提供者的PA建议（校正比值比 = 1.21；95%置信区间 = 1.00 - 1.47）。
有CVD风险因素且未达到PA指南的美国成年人更有可能收到提供者关于增加PA的建议，但只有一半人收到此类建议。需要采取策略增加提供者的建议，以提高超重/肥胖且有其他CVD风险因素的美国成年人对USPSTF指南的依从性。
