Determinants of Dutch general practitioners’ nutrition and physical activity guidance practices

Abstract

Objective: General practitioners (GP) are uniquely placed to guide their patients on nutrition and physical activity. The aims of the present study were to assess: (i) the extent to which GP guide on nutrition and physical activity; (ii) the determinants that cause GP to give guidance on nutrition and physical activity; and (iii) the extent to which these guidance practices have the same determinants. Design: Cross-sectional study, mail questionnaire. Setting: Dutch general practice. Subjects: Four hundred and seventy-two GP in practice for 5-30 years. Results: Our study showed that the majority of GP had similar practices for both nutrition and physical activity guidance. Fair associations were found between nutrition and physical activity guidance practices. More than half of the explained variance in the models of physical activity guidance practices was improved by the inclusion of nutrition guidance practices in the models. Moreover, GP reported higher frequencies of physical activity guidance practices than nutrition guidance practices. Nutrition guidance practices predicted the same physical activity guidance practices. Conclusions: The majority of GP had similar practices for nutrition and physical activity guidance. GP were more inclined to guide their patients on physical activity than on nutrition. Self-efficacy was found to be a determinant in most models for guidance practices. Guidance practices proved to be a mix of prevention and treatment components. Consequently, we advise raising the selfefficacy of GP by training in medical school and in continuing medical education. We also recommend the combination of both nutrition and physical activity guidance in general practice.

Present and future of nutrition guidance : lifestyle advice in primary care

“…There is a discrepancy between patients` expectations and GPs`performance, which needs urgent attention! In a cross-sectional study, we assessed the determinants of Dutch general practitioners` nutrition and physical activity guidance practices (among 472 GPs in practice for 5-30 years) (127). The majority of GPs had similar practices for nutrition and physical activity guidance.…”

Examining the content of weight, nutrition and physical activity advices provided by Dutch practice nurses in primary care: analysis of videotaped consultations

“…The relatively few studies that examined lifestyle counseling among PNs compared with GPs (Table 1) found that PNs self-reported higher frequencies of lifestyle counseling practices [14][15][16][17] than GPs. 15,[18][19][20][21][22][23][24][25][26][27][28][29] In observational studies, lifestyle was more frequently discussed during PNs' 30,31 than GPs' visits. [30][31][32][33][34][35][36][37] Only two studies have looked at the combination of GPs' nutrition and physical activity counseling.…”

“…[30][31][32][33][34][35][36][37] Only two studies have looked at the combination of GPs' nutrition and physical activity counseling. 29,35 More specifically for obesity prevention, an up-to-date review revealed that the content of GPs' advice about nutrition and physical activity is very general, only a few communication strategies are actually used, and combined lifestyle advice occurs rarely. 38 Merely a small number of observational studies about weight counseling by GPs were identified in this review.…”

Setting goal and implementation intentions in consultations between practice nurses and patients with overweight or obesity in general practice

“…They could apply different communication styles to deal with this situation of low motivation, but it seems like they are still experiencing barriers. Perceived barriers were often found in studies among general practitioners (28)(29)(30)(31)(32)(33)(34)(35)(36)(37) . Barriers need to be addressed before the achievement of shared goals can become common practice (52) .…”

“…A recent study showed that practice nurses seem to fail to adequately emphasize this advice (27) . However, studies among general practitioners showed that their actual nutrition guidance practices are not only determined by predisposing factors and driving forces, but also by perceived barriers (28)(29)(30)(31)(32)(33)(34)(35)(36)(37) . In the same way, real-life practice nurse-patient consultations might also deviate from the ideal practice.…”