Physicians' perceptions of their role in cardiovascular risk reduction

Mann, Karen; Putnam, Robert W.

doi:10.1016/0091-7435(89)90053-4

Cited by 44 publications

(13 citation statements)

References 12 publications

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“…It is therefore important that general practitioners indeed acknowledge and support their potential role in cardiovascular risk reduction (Mann & Putnam, 1989;Mirand et al, 2002). In practice, unfortunately, the level of preventive services usually lags behind the guidelines and recommendations (Cohen et al, 1994;Yarnall et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Potentials and pitfalls for nutrition counselling in general practice

et al. 2005

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Section: Discussionmentioning

confidence: 99%

Potentials and pitfalls for nutrition counselling in general practice

et al. 2005

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“…So far, studies searching for determinants of nutrition guidance practices of PCPs have been limited to identifying perceived barriers of PCPs as discussed before (Hiddink, 1996;Hiddink et al, 1997b) or by addressing speci®c areas, such as cardiovascular risk reduction (Mann & Putnam, 1989;Ammerman et al, 1993;Glanz & Gilboy, 1992). In a previous cross-sectional study (Hiddink et al, 1995), determinants of nutrition guidance practices of PCPs were identi®ed (Hiddink et al, 1997a), as well as their mechanism of action (Hiddink et al, 1997b).…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional and longitudinal analyses of nutrition guidance by primary care physicians

Hiddink¹,

Hautvast

Woerkum

et al. 1999

Eur J Clin Nutr

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Objective: To investigate in primary care physicians (PCPs) the determinants of a nutrition guidance practice (`noticing patients' overweight and guidance of treatment'), as well as their mechanism of action, in a crosssectional and a longitudinal approach. Design: Mixed longitudinal design. Five years follow up study of a previous cross-sectional study in October 1992. Subjects: A representative sample of 675 Dutch PCPs, in practice for 5 up to 20 y. Interventions: A shortened version of the Wageningen PCPs Nutritional Practices Questionnaire was mailed to the subjects in August 1997. Main outcome measure: To obtain with the LISREL-program a model of the mechanism of action of determinants of the dependent variable`noticing patients' overweight and guidance of treatment' with an adequate ®t of the empirical data, both in the cross-sectional and in the longitudinal approach. Results: The same set of predisposing factors and intermediary factors explains the dependent variable both in two different representative cross-sectional study populations of PCPs, and in a cohort cross-sectional study at two points in time.Two dynamic LISREL-models were developed (the`determinant-longitudinal approach' and the`early behaviour longitudinal approach') which explain the dependent variable. The latter model has, as added value, a gain in explained variance. In 5 y time, the dependent variable decreased signi®cantly (P`0.001).Conclusions: This study recon®rms that PCPs' nutritional guidance practices are determined partly directly by predisposing factors, and indirectly via driving forces and barriers. However this study also reveals that an important nutrition guidance practice of PCPs,`noticing patients' overweight and guidance of treatment', shows a signi®cant decrease over the last 5 y. At the same time, two of the four predisposing factors and two of the three driving factors also decreased signi®cantly. As research ®ndings indicate that the role of diet in health and disease becomes of greater in¯uence PCPs need to be activated to apply their responsibility in this ®eld within a multi-faceted approach. Sponsorship: The study was supported by the Dutch Dairy Foundation on Nutrition and Health, Maarssen, The Netherlands.

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“…Many per ceived barriers as well as some driving forces have been identified in the search for determinants of nutrition guidance practices of PCPs (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), PCPs perceive a lack of nutritional knowledge and skills in their patient nutrition guidance, both in general and in special fields, eg, prevention and treatment of overweight and of coronary artery disease (3,7,11,14,16). Orleans et al (4) found that PCPs underutilized potentially effective methods of patient nutrition guidance and behavioral change and overutilized less effective methods.…”

Section: Introductionmentioning

confidence: 99%

Information sources and strategies of nutrition guidance used by primary care physicians

Hiddink¹,

Hautvast²,

Woerkum³

et al. 1997

The American Journal of Clinical Nutrition

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We studied the nutrition information seeking behavior of primary care physicians (PCPs) ancl also PCPs' im plementation of different strategies of nutrition guidance of pa tients. This was done by means of a questionnaire mailed to a nationwide random sample of 1000 PCPs in the Netherlands. The net response rate was 64%, The two most important nutrition information sources for PCPs were a dietitian (72% of respon dents) and the literature (34% of respondents). Eighty-five percent of PCPs reported that they were actively involved in seeking nutrition information. For nutrition education of patients, PCPs gave personal information to patients, referred patients to a dieti tian, and made publications available in the surgery. As preferred methods of obtaining nutrition information themselves, PCPs listed scientific journals, postgraduate nutrition education, con gresses and study days, and publications. Determinants of nutrition information seeking behavior of PCPs as well as their implemen tation of different strategies of patient nutrition education were identified and discussed. PCPs were familiar with the body mass index, which is encouraging because treatment of overweight and obesity starts with a valid assessment. The findings in this study lead to a prudent positive conclusion about PCPs and nutrition information in practice. From this study and others it can be concluded that there are growing opportunities, challenges, and tools for PCPs to become more actively involved in nutrition guidance of patients.

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Physicians' perceptions of their role in cardiovascular risk reduction

Cited by 44 publications

References 12 publications

Potentials and pitfalls for nutrition counselling in general practice

Potentials and pitfalls for nutrition counselling in general practice

Cross-sectional and longitudinal analyses of nutrition guidance by primary care physicians

Information sources and strategies of nutrition guidance used by primary care physicians

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