Smith Jordan, Ylitalo Kelly R
Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
Prev Med. 2021 Dec;153:106730. doi: 10.1016/j.ypmed.2021.106730. Epub 2021 Jul 18.
Adults with functional limitations are more likely to be physically inactive than those without functional limitations, despite evidence that regular physical activity (PA) slows the progression of functional decline. The health care setting provides an opportunity to communicate with patients about positive behavior changes, including increased PA, but there is little information about provider recommendation for PA to adults with functional limitations. This study investigated health care provider recommendation to increase PA among adults with and without functional limitations. Adults (≥18 years) who participated in the 2016 National Health Interview Survey and reported ≥1 primary care encounter within the previous 12 months were included (unweighted n = 23,540; weighted N = 170,004,764). Receipt of PA recommendation and physical functioning limitations were self-reported. Statistical analyses were weighted to account for complex survey sampling design. One-third (35.88%) of adults received a PA recommendation and 19.71% reported functional limitations. Adults who received a PA recommendation were more likely to have a functional limitation than those who did not (28.64% vs. 14.70%; p < 0.001), even after adjusting for covariates and current activity level (aOR = 1.48; 95% CI:1.33,1.65). PA recommendation for those with functional limitations appeared to increase during middle age and peak for adults aged 65-75 years (57.01%) but declined substantially for adults ≥75 years. Only one-third of adults in the United States received PA recommendations. Health care providers recommended PA to approximately half of adults with functional limitations. Continued efforts to leverage health care encounters for behavior change should be explored, particularly for middle aged and older adults.
尽管有证据表明定期体育活动(PA)可减缓功能衰退的进程,但与没有功能限制的成年人相比,有功能限制的成年人身体活动不活跃的可能性更大。医疗保健机构为与患者交流积极的行为改变(包括增加体育活动)提供了机会,但关于医疗服务提供者向有功能限制的成年人推荐体育活动的信息却很少。本研究调查了医疗服务提供者对有和没有功能限制的成年人增加体育活动的推荐情况。纳入了参加2016年国家健康访谈调查且报告在过去12个月内有≥1次初级保健就诊经历的成年人(≥18岁)(未加权n = 23,540;加权N = 170,004,764)。体育活动推荐的接受情况和身体功能限制通过自我报告获得。统计分析进行了加权以考虑复杂的调查抽样设计。三分之一(35.88%)的成年人收到了体育活动推荐,19.71%报告有功能限制。即使在调整协变量和当前活动水平后,收到体育活动推荐的成年人比未收到推荐的成年人更有可能存在功能限制(28.64%对14.70%;p < 0.001)(调整后比值比[aOR] = 1.48;95%置信区间[CI]:1.33,1.65)。对有功能限制者的体育活动推荐在中年时期似乎有所增加,在65 - 75岁成年人中达到峰值(57.01%),但在≥75岁的成年人中大幅下降。在美国,只有三分之一的成年人收到了体育活动推荐。医疗服务提供者向大约一半有功能限制的成年人推荐了体育活动。应探索继续利用医疗保健就诊来促进行为改变的努力,特别是针对中年和老年人。