Guglielmo Dana, Murphy Louise B, Theis Kristina A, Helmick Charles G, Omura John D, Odom Erica L, Croft Janet B
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, 1242Centers for Disease Control and Prevention, Atlanta, GA, USA.
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Am J Health Promot. 2021 May;35(4):559-570. doi: 10.1177/0890117120981371. Epub 2020 Dec 24.
To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis.
Cross-sectional.
2018 DocStyles online national market research survey of US physicians and nurse practitioners.
1,389 PCPs seeing adults with arthritis.
2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: "always assesses," "always recommends," and "both" ("always assesses and recommends").
Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression.
Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly ("both": 56.4%; "always assesses": 66.7%; "always recommends": 71.3%) and lowest among obstetrician/gynecologists ("both": 26.9%; "always assesses": 36.8%; "always recommends": 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of "always assesses" (PR = 1.5 [95% confidence interval (CI): 1.3-1.8] and "both" (PR = 1.6 [95% CI: 1.4-1.9]).
Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.
研究初级保健提供者（PCP）对患有关节炎的成年人进行身体活动评估及推荐的行为。
横断面研究。
2018年对美国医生和执业护士进行的DocStyles在线全国市场研究调查。
1389名诊治患有关节炎成年人的初级保健提供者。
将两种独立行为（评估和推荐）分为3个非互斥组：“总是评估”、“总是推荐”和“两者都做”（“总是评估并推荐”）。
计算每组的百分比（总体及按初级保健提供者特征），并使用二元逻辑回归计算多变量调整患病率比（PR）。
在初级保健提供者中，49.2%总是进行评估，57.7%总是推荐身体活动；39.7%两者都做。在所有3组中，每周诊治≥20名患有关节炎成年人的比例最高（“两者都做”：56.4%；“总是评估”：66.7%；“总是推荐”：71.3%），在妇产科医生中比例最低（“两者都做”：26.9%；“总是评估”：36.8%；“总是推荐”：40.7%）。多变量调整后的关联在每周诊治≥20名患有关节炎成年人时最强（参照组：1 - 9名成年人），以及“总是评估”（PR = 1.5 [95%置信区间（CI）：1.3 - 1.8]）和“两者都做”（PR = 1.6 [95% CI：1.4 - 1.9]）时。
约40%的抽样初级保健提供者总是对患有关节炎的成年人同时进行两种行为（评估和推荐身体活动）；诊治大量患有关节炎的成年人始终与参与每种行为相关。支持初级保健提供者咨询的循证方法包括提供提供者教育和培训、提高对可用资源的认识以及利用卫生系统支持。
