Physicians, preventive care, and applied nutrition

Glanz, Karen; Gilboy, Mary Beth

doi:10.1097/00001888-199211000-00016

Cited by 27 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During the ®rst International Workshop`Nutritional attitudes and practices of primary care physicians' (December 1995, Heelsum, The Netherlands; proceedings published as a Supplement of the American Journal Clinical Nutrition, June 1997), Glanz reviewed the extent of nutrition counselling in the United States and in Europe (Glanz, 1997). Most studies focused primarily on counselling for high blood cholesterol and obesity and revealed that 50 ± 75% of PCPs report conducting some nutrition counselling in their practice (Wiesemann, 1997;Glanz & Gilboy, 1992;Glanz et al, 1995;Levine et al, 1993). According to a recent study, some aspects of nutrition (for example excess energy consumption and consumption of a balanced diet) are considered to be less important than they were a decade ago (Wechsler et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

“…Glanz & Gilboy reviewed nine studies of cholesterol management and counselling in which data were collected with observations, chart audits and surveys of patients. They found rates of nutrition counselling ranging from 17% to 70% (Glanz & Gilboy, 1992).…”

Section: Introductionmentioning

confidence: 99%

“…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%

See 2 more Smart Citations

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

Hiddink¹,

Hautvast

Woerkum

et al. 1999

Eur J Clin Nutr

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Hiddink¹,

Hautvast

Woerkum

et al. 1999

Eur J Clin Nutr

View full text Add to dashboard Cite

show abstract

“…The determinants of nutri tion guidance practices of PCPs are poorly understood. So far, studies searching for determinants of nutrition guidance practices of PCPs have been limited to iden tifying perceived barriers of PCPs [2, or address ing specific areas, such as cardiovascular risk reduc tion [11][12][13]. We have found that nutrition guidance practices of PCPs in the Netherlands are determined on the one hand by a number of perceived barriers such as lack of nutrition training and education and lack of time [14,15], and on the other hand by several driving forces, such as an active interest in the effect of nutri tion on health and disease [15].…”

Section: Introductionmentioning

confidence: 99%

Nutrition Guidance by Primary-Care Physicians: LISREL Analysis Improves Understanding

Hiddink¹,

Hautvast

Woerkum

et al. 1997

Preventive Medicine

View full text Add to dashboard Cite

1 G e r r it J. H id d in k , P h .D .,* '2 J o s e p h G. A. J. H a u t v a s t , M .D .,t C e e s M . J. v a n W o e r k u m , P h .D .,$ C a r e l J. F ie r e n , M.D., § a n d M a r t in A . v a n 't H o f , P h .D .ÎI Nutrition and Health, Zonnebaan 12D, 3606 CA Maarsaen, the Background. When determ inants of nutrition guid ance practices for primary care physicians (PCPs) are id en tified, the key q u estion rem ains: w hat is th e mechanism of action? This knowledge is essential in order to understand how PCPs practice n u trition guidance. * Daily Foundation forMethods. Mail questionnaires (result of focus-group discussions and in-depth interview s) were sent to a nationwide random sample of 1,000 PCPs in the N eth erlands, who had been in practice for betw een 5 and 15 years (633 respondents). The m echanism of action o f determ inants of nutrition guidance practices of PCPs was identified by means of linear structural relation ship analysis (LISREL) using a postulated model.Results. The postulated model on the mechanism of action was confirmed. The model demonstrates that nutrition guidance practices of PCPs are directly and significantly based on a few predisposing factors; driv ing forces and perceived barriers may act as signifi cant intermediary variables. The predisposing factors, driving forces, and perceived barriers were identified.Conclusion. Policies to improve nutrition guidance practices of PCPs may, in the future, benefit from a LISREL model analysis of determ inants of these prac tices to become more effective. Using multiple regres sion analysis to ascertain the determ inants of these practices could result in m issing important predispos ing factors and "hidden" interm ediary factors and lead, therefore, to an incom plete understanding of the mechanism of action. © lf)97 A cad em ic P ro sa

show abstract

“…Physician advice/counselling can be an effective method for patient behaviour change, and thus an important contributor to public health 3,4 . However, a relatively small proportion of primary care physicians provide nutritional advice to their patients, owing to discomfort in giving such advice, lack of time and a perceived lack of patient interest 5,6 . An additional barrier to physician involvement in dietary counselling is lack of accurate information on patients' diets.…”

mentioning

confidence: 99%

PrimeScreen, a brief dietary screening tool: reproducibility and comparability with both a longer food frequency questionnaire and biomarkers

Rifas‐Shiman

Willett

Lobb

et al. 2001

Public Health Nutr.

184

164

View full text Add to dashboard Cite

Objective: Diet is an important determinant of health outcomes, but physicians have few ways to identify persons with suboptimal diets. The purposes of this study were to examine the reproducibility of a short dietary assessment questionnaire (PrimeScreen) and to compare its results with those of a longer food frequency questionnaire and with plasma levels of selected nutrients. Design: Each subject completed two PrimeScreen questionnaires at an interval of 2 weeks and one full length, 131-item, semiquantitative food frequency questionnaire (SFFQ), and had a sample of blood drawn. We compared the PrimeScreen with two reference standards, the SFFQ and plasma levels of selected nutrients. Setting: A large managed care organization in New England. Subjects: A total of 160 men and women, aged 19±65 years, participated. Results: For foods and food groups, the mean correlation coefficient (r) was 0.70 for reproducibility and 0.61 for comparability with the SFFQ. For nutrients, the mean r was 0.74 for reproducibility and 0.60 for comparability with the SFFQ. No substantial differences were evident by sex, race, body mass index, occupation or education. Correlation coefficients for the comparison of vitamin E, b-carotene and lutein/ zeaxanthin intakes from the PrimeScreen with plasma levels were 0.33, 0.43 and 0.43, respectively. These values were similar to those comparing the SFFQ with plasma levels. The median time to complete PrimeScreen was 5 min; 87% of participants required fewer than 10 min. Conclusions: A quick way to assess quality of diet among adults, PrimeScreen has adequate reproducibility and its results compare well with a longer food frequency questionnaire and biomarkers.

show abstract

Physicians, preventive care, and applied nutrition

Cited by 27 publications

References 0 publications

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

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

Nutrition Guidance by Primary-Care Physicians: LISREL Analysis Improves Understanding

PrimeScreen, a brief dietary screening tool: reproducibility and comparability with both a longer food frequency questionnaire and biomarkers

Contact Info

Product

Resources

About