The content of diet and physical activity consultations with older adults in primary care

Abstract

Objective Despite numerous benefits of consuming a healthy diet and receiving regular physical activity, engagement in these behaviors is suboptimal. Since primary care visits are influential in promoting healthy behaviors, we sought to describe whether and how diet and physical activity are discussed during older adults’ primary care visits. Methods 115 adults ages 65 and older consented to have their routine primary care visits recorded. Audio-recorded visits were transcribed and diet and physical activity content was coded and analyzed. Results Diet and physical activity were discussed in the majority of visits. When these discussions occurred, they lasted an average of a minute and a half. Encouragement and broad discussion of benefits of improved diet and physical activity levels were the common type of exchange. Discussions rarely involved patient behavioral self-assessments, patient questions, or providers’ recommendations. Conclusions The majority of patient visits include discussion of diet and physical activity, but these discussions are often brief and rarely include recommendations. Practice Implications Providers may want to consider ways to expand their lifestyle behavior discussions to increase patient involvement and provide more detailed, actionable recommendations for behavior change. Additionally, given time constraints, a wider array of approaches to lifestyle counseling may be necessary.

Self‐management support in routine primary care by nurses

“…In this study, nurses tended to prioritize the optimization of patients' medical treatment according to the health care standards; they educated patients about monitoring and controlling their condition and gave advice, seeking little input from patients' own perspective. The finding that primary care nurses address health behaviours, such as being physically active, briefly and in a fragmented way has also been found in other studies (Bardach & Schoenberg, 2014;Noordman et al, 2013;van Dillen, Noordman, van Dulmen, & Hiddink, 2014). The behaviours 'dietary intake' and 'physical activity' were the most frequently addressed behaviours during the consultations, which is in line with results from another Dutch study among primary care nurses (Noordman et al, 2013).…”

A qualitative exploration of the experiences of primary care patients engaged in email counseling meant to increase physical activity

“…Unfortunately, papers that qualitatively analyze the content of PA counseling in primary care are rare (Bardach & Schoenberg, 2014;Carroll, Antognoli, & Flocke, 2011), which might be explained by the inconvenience of recording face-to-face or telephone counseling sessions. Fortunately, with the advent of emailbased interventions (Hageman et al, 2017;Hatchett, Hallam, & Ford, 2012), this inconvenience could be overcome as the content of the counseling is automatically stored on an email server.…”

Primary Care Providers’ Level of Preparedness for Recommending Physical Activity to Adults With Disabilities

“…Other patient-related barriers were perceptions that patients lack interest or are unable to participate in physical activity. One possible solution may be to weave a recommendation for physical activity into discussions of other related health issues, such as falls, balance, and endurance, rather than addressing physical activity separately ( 29 ). Merging these discussions may also assist primary care providers who cite lack of time as their primary barrier (16% of primary care providers in our study).…”