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医生对健康的社会决定因素(SDoH)的认知对生活方式医学实践的影响。家庭医生调查结果

Impact of Physicians' Perception of Social Determinants of Health (SDoH) on the Practice of Lifestyle Medicine. Findings From a Family Physicians Survey.

作者信息

Bharati Rajani, Kovach Kevin A, Sayess Polina, Polk Elizabeth

机构信息

Population and Community Health, American Academy of Family Physicians, Leawood, KS, USA (RB).

Kansas Health Institute, Topeka, KS, USA (KAK).

出版信息

Am J Lifestyle Med. 2024 Nov 15:15598276241277460. doi: 10.1177/15598276241277460.

Abstract

Lifestyle Medicine emphasizes evidence-based lifestyle changes to address chronic conditions Yet, concerns have emerged regarding its ability to address broader social determinants of health (SDoH). This study examines how family physicians' perceptions of SDoH relate to their use of lifestyle medicine competencies. This cross-sectional survey was administered to 5770 family physicians. Participants rated the importance of LM core competencies and the impact of community conditions on patient health. Data analysis involved descriptive statistics, factor analysis, regression models, and t-tests. This study encompassed 447 responses. The findings revealed that while respondents recognized the effect of certain SDoH, such as access to unhealthy food (89%), alcohol (86%), and tobacco (83%), they showed less awareness of factors like racism and discrimination (53%), and access to parks (56%) or education (60%). Gender and the level of social deprivation in their area were significant factors influencing respondents' perception of SDoH impact. Additionally, those who valued and used lifestyle medicine core competencies were more likely to acknowledge the influence of SDoH on patient health. Our findings suggest that comprehensive education on SDoH, especially with a focus on community aspects, is crucial across all levels of medical training to address this gap and ensure equitable care.

摘要

生活方式医学强调基于证据的生活方式改变以应对慢性病。然而,人们对其解决更广泛的健康社会决定因素(SDoH)的能力产生了担忧。本研究调查了家庭医生对SDoH的认知与他们对生活方式医学能力的运用之间的关系。这项横断面调查针对5770名家庭医生进行。参与者对生活方式医学核心能力的重要性以及社区状况对患者健康的影响进行了评分。数据分析包括描述性统计、因子分析、回归模型和t检验。本研究共收到447份回复。研究结果显示,虽然受访者认识到某些SDoH的影响,如获取不健康食品(89%)、酒精(86%)和烟草(83%),但他们对种族主义和歧视(53%)、公园使用情况(56%)或教育(60%)等因素的认识较少。性别以及他们所在地区的社会剥夺程度是影响受访者对SDoH影响认知的重要因素。此外,那些重视并运用生活方式医学核心能力的人更有可能承认SDoH对患者健康的影响。我们的研究结果表明,在各级医学培训中,对SDoH进行全面教育,尤其是关注社区方面,对于弥补这一差距并确保公平医疗至关重要。

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本文引用的文献

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The Built Environment as a Social Determinant of Health.作为健康社会决定因素的建筑环境
Prim Care. 2023 Dec;50(4):591-599. doi: 10.1016/j.pop.2023.04.012. Epub 2023 Jun 9.
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Expanding Implementation Research to Prevent Chronic Diseases in Community Settings.扩大实施研究以预防社区环境中的慢性病。
Annu Rev Public Health. 2021 Apr 1;42:135-158. doi: 10.1146/annurev-publhealth-090419-102547. Epub 2021 Jan 19.

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