Physical activity counseling knowledge, attitudes, and practices among nurse practitioners and physician assistants

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Description

Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers'

Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.

Date Created
2011
Agent

An ecological approach to investigating the influences of obesity

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Description
"Globesity," as defined by the World Health Organization, describes obesity as a pandemic affecting at least 400 million people worldwide. The prevalence of obesity is higher among women than men; and in non-Hispanic black and Hispanic populations. Obesity has been

"Globesity," as defined by the World Health Organization, describes obesity as a pandemic affecting at least 400 million people worldwide. The prevalence of obesity is higher among women than men; and in non-Hispanic black and Hispanic populations. Obesity has been significantly associated with increased all-cause mortality, and mortality from cardiovascular disease, obesity-related cancers, diabetes and kidney disease. Current strategies to curb obesity rates often use an ecological approach, suggesting three main factors: biological, behavioral, and environmental. This approach was used to develop four studies of obesity. The first study assessed dietary quality, using the Healthy Eating Index (HEI)-2005, among premenopausal Hispanic and non-Hispanic white women, and found that Hispanic women had lower total HEI-2005 scores, and lower scores for total vegetables, dark green and orange vegetables and legumes, and sodium. Markers of obesity were negatively correlated with total HEI-2005 scores. The second study examined the relationship between reported screen time and markers of obesity among premenopausal women and found that total screen time, TV, and computer use were positively associated with markers of obesity. Waist/height ratio, fat mass index, and leptin concentrations were significantly lower among those who reported the lowest screen time versus the moderate and high screen time categories. The third study examined the relationship between screen time and dietary intake and found no significant differences in absolute dietary intake by screen time category. The fourth study was designed to test a brief face-to-face healthy shopping intervention to determine whether food purchases of participants who received the intervention differed from those in the control group; and whether purchases differed by socioeconomic position. Participants in the intervention group purchased more servings of fruit when compared to the control group. High-income participants purchased more servings of dark green/deep yellow vegetables compared to those in the low-income group. Among those who received the intervention, low-income participants purchased foods of lower energy density, and middle-income participants purchased food of higher fat density. The findings of these studies support policy changes to address increasing access and availability of fruits and vegetables, and support guidelines to limit screen time among adults.
Date Created
2010
Agent