The Medically Underserved: Who Is Likely to Exercise and Why?

Abstract

Adults who exercise regularly have better health, but only 15% of U.S. adults engage in regular exercise, with some social groups, such as people with lower incomes and women, having even lower rates. This study investigates the rate at which medically underserved patients receive exercise counseling from health care providers, characteristics of those who exercise, and barriers and motivations to exercise. The convenience sample was predominantly female and White and exclusively low-income and uninsured or underinsured. On average, participants were obese, by Federal Obesity Guidelines; 43% smoked. Although 60% of 126 patients reported that providers discussed exercise with them, the discussions had no relationship with patients' engagement in exercise. Women and those with lung problems, diabetes, or children in the home were less likely than others surveyed to exercise. The highest rated motivations included body image and health issues. The most important barriers were time, cost, and access to exercise facilities and equipment. In order for exercise counseling to be more effective, health care providers' interventions must consider patients' personal characteristics, health status, readiness to engage in an exercise program, and motivations and barriers to exercise.

Setting Overweight Adults in Motion: The Role of Health Beliefs

“…A primary motivation (cue) for obese individuals to decide to participate in weight loss treatment in medical centers is health impairment [19,56]. In the present study, most participants confirmed that a main reason for starting physical exercise now or in future was or would be actual or possible health risks, but the exercise and non-exercise group did not differ in this respect.…”

Relationships between lifestyle, health behaviors, and health status outcomes for underserved adults

“…The relationship between exercise and BMI was positive, further supporting concerns regarding the validity of how exercise was measured in this population. However, it should be noted that Schrop, Pendleton, McCord, Gil, Stockton, McNatt, et al (2006) did find the medically underserved were exercising more frequently than expected, although more men were exercising than women.…”

“…The 12‐Item Short‐Form Health Survey (SF‐12; Ware, Kosinski, & Keller, 1996) has been used in a variety of studies as a measure of physical, mental, and general health status (Adams, Wilson, Taylor, Daly, d'Espaignet, Dal Grande, et al, 2006; Bharmal & Thomas, 2005; Cockerill, Lunt, Silman, Cooper, Lips, Bhalla, et al, 2004; Kroenke, Kubzanski, Adler, & Kawachi, 2008; Larson, Schlundt, Patel, Beard, & Hargreaves, 2008; Mainous, Griffith, & Love, 1999; Resnick, 2002; Salomon, 1996; Salsberry, Nickel, Polivka, Kuthy, Slack, & Shapiro, 1999; Schrop, Pendleton, McCord, Gil, Stockton, McNatt, et al, 2006); however, only a few of these studies have focused on the underserved. A significant level of self‐reported depression was found in a study of 479 young, low‐income mothers (Salsberry et al, 1999).…”

Weight Management and Hypertension Services in a Rural Public Health Clinic

“…Research in the northern US found that women with a chronic condition were less likely to exercise than men, and other than diabetes and a respiratory condition, chronic disease is not an indicator of daily exercise [20]. The same study found respondents with minors were less likely to be currently exercising or had any intention to do so.…”