Healthy and Fit for Prevention: The Influence of Clinician Health and Fitness on Promotion of Healthy Lifestyles During Health Supervision Visits

Abstract

To understand the relationship between pediatricians' personal health and the delivery of pediatric preventive care, Illinois pediatricians were surveyed by mail. Responses from 387 pediatricians (55% response rate) regarding personal characteristics, their practice, and perceptions about preventive care patterns for children aged 2 through 10 years and management of overweight children were analyzed. Overall, 28% of pediatricians were healthy and fit (excellent/very good health and extremely/ very fit), 40% were either healthy or fit, and 33% were neither healthy nor fit. In logistic regression models controlling for personal and practice characteristics, healthy and fit pediatricians (vs neither healthy nor fit pediatricians) more routinely provided recommended care on child diet (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.6-6.2) and physical activity (OR, 3.2; 95% CI, 1.6-6.3) and assessed television time (OR, 4.4; 95% CI, 2.0-10.1). Pediatricians who were either healthy or fit (vs pediatricians who were neither healthy nor fit) more often assessed television time. Therefore, clinician health influenced application of preventive care.

Health Supervision Visits of Very Young Children: Time Addressing 3 Key Topics

“…A survey of pediatricians in Illinois also reported high frequencies of interpretations of weight-for-age and height-for-age. 17 Consistent with what we observed, medical records rarely have growth interpretation (ie, plotting of weight-for-height) during infancy. 18 The median of 9 seconds to address growth was similar to the median 15 seconds reported by Martin et al 14 at HS visits of children aged 2-10 years using this same observation method.…”

The Evidence in Support of Physicians and Health Care Providers as Physical Activity Role Models

“…Even those who perceived themselves as healthy and fit recommended PA more frequently (OR 3.2, CI 1.6-6.3) and assessed sedentary behavior such as TV viewing (OR 4.4, CI 2.0-10.1) more frequently among their patients. 66 Frank has studied this association in-depth, among Canadian physicians, 65 US physicians, 20 and medical students. 38 Among a sample of female physicians in the United States, those who complied with PA recommendations were more likely to counsel patients about exercise ( P = .004).…”

“…However, and partly because of HCPs' PA habits have room for improvement, PA counseling rates by HCPs still remain unacceptably low in many countries. For * References 22,56,59,64,66,70. example, it is estimated that less than 40% of US primary care providers provide regular counseling on PA, even though PA counseling is a national health objective and many physician professional and scientific organizations recommend counseling on PA. 83 On the other hand, more information is needed on the PA habits of HCPs other than physicians. Some studies report that nurses are somewhat more active than the general population, but when compared with physicians, studies show they have poorer health habits and report more barriers to engage in PA. 43,46 However, nurses do report being more motivated and are enthusiastic about counseling on PA, and they ranked exercise as an important strategy to address NCDs among their patients.…”

Physical Activity Assessment and Counseling in Pediatric Clinical Settings

“…178,179 Interestingly, the greatest predictor of asking about physical activity by pediatricians is being personally "fit and healthy" themselves. 180 In addition, physical activity is integral to personal wellbeing for the health care professional, improving quality of life and work-life balance and decreasing burnout. [181][182][183][184] The AAP has published a clinical report on the subject.…”