Views of Primary Care Physicians Regarding the Promotion of Healthy Lifestyles and Weight Management Among Their Patients

Survey Administration

The survey was administered anonymously through Qualtrics, a secure, online survey platform. The survey was administered online to increase anonymity, increase response rate, and diminish potential physician-perceived barriers to participating in the study. The participating physicians were provided with a link that enabled them to access the survey. The survey excluded questions that required disclosure of identifying information. Survey data from Qualtrics were exported to an SPSS file that was stored on a password protected, secured computer in the research lab of the principal investigator for this study.

Data Analysis

Frequency analyses were applied to survey responses to determine the participating physicians’ endorsed barriers to and views regarding evaluating and managing patients’ weight, healthy eating, and physical activity; physicians’ views related to helping patients achieve and maintain a health-promoting lifestyle and a healthy weight; and physicians’ healthy lifestyle–related knowledge. Nonparametric t tests were conducted to examine differences in survey responses of the participating physicians in association with their sex (male or female), race (Asian vs. white/Caucasian), and BMI (BMI < 25 and BMI ≥ 25).

Approval for the study was obtained through the institutional review board of the University of Florida Health Science Center.

Results

Participants

Twenty-five physicians out of 52 invited completed the survey (48% response rate). The vast majority of the study participants were PCMH-affiliated (92%–96%). Participating physicians ranged in age from 29 to 67 years old. Sixteen (64%) participating physicians identified as female, 7 (28%) participating physicians identified as male, and 2 (8%) participating physicians did not indicate a sex. Twenty (80%) participating physicians identified as being white, 3 (12%) participating physicians identified as being Asian/Asian American, and 2 (8%) did not indicate a race or ethnicity. Twenty-two (88%) participating physicians were employees of a large medical group affiliated with an academic medical center, 1 (4%) was employed in a physician-owned practice, and 2 (8%) did not indicate their main primary care practice location. Table 1 provides additional demographic data.

Approximately 88% of the participating physicians agreed that patients were more likely to adopt healthier lifestyles if their health care providers counseled them to do so (44% strongly agreed, 44% agreed somewhat). A majority of participating physicians endorsed the view that there are effective strategies and/or tools to (a) help patients eat a healthy diet (56% strongly agreed, 24% agreed somewhat), (b) engage in adequate amounts of physical activity (56% strongly agreed, 20% agreed somewhat), and (c) maintain a healthy weight or lose weight (48% strongly agreed, 

Many participating physicians expressed confidence in their ability to counsel their patients to (a) eat a healthy diet (64% strongly agreed, 28% agreed somewhat), (b) engage in adequate amounts of physical activity (68% strongly agreed, 24% agreed somewhat), and (c) maintain a healthy weight or lose weight (60% strongly agreed, 32% agreed somewhat). Most participating physicians at least somewhat agreed that they were effective at helping their patients (a) eat a healthy diet (24% strongly agreed, 52% agreed somewhat), (b) engage in adequate amounts of physical activity (20% strongly agreed, 56% agreed somewhat), and (c) maintain a healthy weight or lose weight (16% strongly agreed, 48% agreed somewhat). Some participating physicians expressed ambivalence about whether or not they were effective at helping their patients (a) eat a healthy diet (16% neither agreed nor disagreed), (b) engage in adequate amounts of physical activity (12% neither agreed nor disagreed), and (c) maintain a healthy weight or lose weight (20% neither agreed nor disagreed). A total of 8% of participating physicians did not endorse the belief that they were effective at helping their patients maintain a healthy weight or lose weight.

Most participating physicians at least somewhat agreed that they were effective in encouraging patients to engage in health-promoting activities (44% strongly agreed, and 44% agreed somewhat), whereas 4% neither agreed nor disagreed that they were effective in providing this encouragement. Interestingly, many participating physicians endorsed the view that they would be able to provide more credible and effective counseling to patients if they (the physicians themselves) ate a healthy diet (68% strongly agreed, 20% agreed somewhat) and engaged in adequate amounts of physical activity (68% strongly agreed, 20% agreed somewhat). A minority of participating physicians (4%) neither agreed or disagreed with this perspective.

In regards to participating physicians’ healthy lifestyle–related knowledge about current BMI ranges for adults or percentile ranges for children, most participating physicians were able to accurately identify the correct BMI cutoff ranges for overweight (80%) and obese (76%) adults. However, only 32% of participating physicians were able to correctly identify BMI percentile ranges for children; however, nearly all of the participating physicians saw mainly adult patients. Lastly, 76% of participating physicians were able to correctly identify the recommended amounts of moderate physical activity for adults 18 years of age and older, and only 56% were able to correctly identify the recommended amount of servings of fruits and vegetables.