Exercise, diet, and weight loss advice in the family medicine outpatient setting

Sue Flocke, Aaron Clark, Katie Schlessman, Ginger Pomiecko

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: The 5A's heuristic (Ask, Assess willingness to change, Advise, Assist, and Arrange follow-up) has been proposed as a general approach to brief health behavior advice. This study's purpose was to discover the extent to which the 5A's heuristic is used to discuss exercise, diet, and weight loss during adult primary care visits and to test if individuals with a greater body mass index (BMI) or a chronic disease are more likely to receive more-comprehensive advice. Methods: We performed a cross-sectional direct observation study of 300 family medicine outpatient visits. Using the 5A's heuristic, the content of each discussion of exercise, diet, and weight loss was documented by an observer. Results: Discussion of exercise, diet, or weight loss occurred in 56% of observed visits, and physicians initiated the majority of the discussions. Advice infrequently included offer of assistance (range 14%-17%) or plans for follow-up (range 3%-10%). Physicians were more likely to provide advice to obese patients and to those with one chronic condition. Twenty percent to 47% of patient-initiated discussions led to no advice. However, trend also suggests that patient-initiated discussions were more likely to lead to a combination of advice and assistance, compared to physician-initiated discussions. Conclusions: Physicians target exercise, diet, and weight loss advice to obese patients and those with chronic conditions. However, the content of the advice rarely includes recommended components that could increase healthy behavior change. Understanding how patients initiate health behavior topics that prompt physicians to provide advice and assistance could lead to patient and physician interventions that increase productive health behavior change discussions.

Original languageEnglish (US)
Pages (from-to)415-421
Number of pages7
JournalFamily medicine
Volume37
Issue number6
StatePublished - Jun 1 2005
Externally publishedYes

Fingerprint

Reducing Diet
Outpatients
Medicine
Exercise
Physicians
Health Behavior
Primary Health Care
Body Mass Index
Chronic Disease
Observation
Heuristics

ASJC Scopus subject areas

  • Family Practice

Cite this

Flocke, S., Clark, A., Schlessman, K., & Pomiecko, G. (2005). Exercise, diet, and weight loss advice in the family medicine outpatient setting. Family medicine, 37(6), 415-421.

Exercise, diet, and weight loss advice in the family medicine outpatient setting. / Flocke, Sue; Clark, Aaron; Schlessman, Katie; Pomiecko, Ginger.

In: Family medicine, Vol. 37, No. 6, 01.06.2005, p. 415-421.

Research output: Contribution to journalArticle

Flocke, S, Clark, A, Schlessman, K & Pomiecko, G 2005, 'Exercise, diet, and weight loss advice in the family medicine outpatient setting', Family medicine, vol. 37, no. 6, pp. 415-421.
Flocke, Sue ; Clark, Aaron ; Schlessman, Katie ; Pomiecko, Ginger. / Exercise, diet, and weight loss advice in the family medicine outpatient setting. In: Family medicine. 2005 ; Vol. 37, No. 6. pp. 415-421.
@article{bcbeb58105a24605b8b83d21acbadab4,
title = "Exercise, diet, and weight loss advice in the family medicine outpatient setting",
abstract = "Background: The 5A's heuristic (Ask, Assess willingness to change, Advise, Assist, and Arrange follow-up) has been proposed as a general approach to brief health behavior advice. This study's purpose was to discover the extent to which the 5A's heuristic is used to discuss exercise, diet, and weight loss during adult primary care visits and to test if individuals with a greater body mass index (BMI) or a chronic disease are more likely to receive more-comprehensive advice. Methods: We performed a cross-sectional direct observation study of 300 family medicine outpatient visits. Using the 5A's heuristic, the content of each discussion of exercise, diet, and weight loss was documented by an observer. Results: Discussion of exercise, diet, or weight loss occurred in 56{\%} of observed visits, and physicians initiated the majority of the discussions. Advice infrequently included offer of assistance (range 14{\%}-17{\%}) or plans for follow-up (range 3{\%}-10{\%}). Physicians were more likely to provide advice to obese patients and to those with one chronic condition. Twenty percent to 47{\%} of patient-initiated discussions led to no advice. However, trend also suggests that patient-initiated discussions were more likely to lead to a combination of advice and assistance, compared to physician-initiated discussions. Conclusions: Physicians target exercise, diet, and weight loss advice to obese patients and those with chronic conditions. However, the content of the advice rarely includes recommended components that could increase healthy behavior change. Understanding how patients initiate health behavior topics that prompt physicians to provide advice and assistance could lead to patient and physician interventions that increase productive health behavior change discussions.",
author = "Sue Flocke and Aaron Clark and Katie Schlessman and Ginger Pomiecko",
year = "2005",
month = "6",
day = "1",
language = "English (US)",
volume = "37",
pages = "415--421",
journal = "Family Medicine",
issn = "0742-3225",
publisher = "Society of Teachers of Family Medicine",
number = "6",

}

TY - JOUR

T1 - Exercise, diet, and weight loss advice in the family medicine outpatient setting

AU - Flocke, Sue

AU - Clark, Aaron

AU - Schlessman, Katie

AU - Pomiecko, Ginger

PY - 2005/6/1

Y1 - 2005/6/1

N2 - Background: The 5A's heuristic (Ask, Assess willingness to change, Advise, Assist, and Arrange follow-up) has been proposed as a general approach to brief health behavior advice. This study's purpose was to discover the extent to which the 5A's heuristic is used to discuss exercise, diet, and weight loss during adult primary care visits and to test if individuals with a greater body mass index (BMI) or a chronic disease are more likely to receive more-comprehensive advice. Methods: We performed a cross-sectional direct observation study of 300 family medicine outpatient visits. Using the 5A's heuristic, the content of each discussion of exercise, diet, and weight loss was documented by an observer. Results: Discussion of exercise, diet, or weight loss occurred in 56% of observed visits, and physicians initiated the majority of the discussions. Advice infrequently included offer of assistance (range 14%-17%) or plans for follow-up (range 3%-10%). Physicians were more likely to provide advice to obese patients and to those with one chronic condition. Twenty percent to 47% of patient-initiated discussions led to no advice. However, trend also suggests that patient-initiated discussions were more likely to lead to a combination of advice and assistance, compared to physician-initiated discussions. Conclusions: Physicians target exercise, diet, and weight loss advice to obese patients and those with chronic conditions. However, the content of the advice rarely includes recommended components that could increase healthy behavior change. Understanding how patients initiate health behavior topics that prompt physicians to provide advice and assistance could lead to patient and physician interventions that increase productive health behavior change discussions.

AB - Background: The 5A's heuristic (Ask, Assess willingness to change, Advise, Assist, and Arrange follow-up) has been proposed as a general approach to brief health behavior advice. This study's purpose was to discover the extent to which the 5A's heuristic is used to discuss exercise, diet, and weight loss during adult primary care visits and to test if individuals with a greater body mass index (BMI) or a chronic disease are more likely to receive more-comprehensive advice. Methods: We performed a cross-sectional direct observation study of 300 family medicine outpatient visits. Using the 5A's heuristic, the content of each discussion of exercise, diet, and weight loss was documented by an observer. Results: Discussion of exercise, diet, or weight loss occurred in 56% of observed visits, and physicians initiated the majority of the discussions. Advice infrequently included offer of assistance (range 14%-17%) or plans for follow-up (range 3%-10%). Physicians were more likely to provide advice to obese patients and to those with one chronic condition. Twenty percent to 47% of patient-initiated discussions led to no advice. However, trend also suggests that patient-initiated discussions were more likely to lead to a combination of advice and assistance, compared to physician-initiated discussions. Conclusions: Physicians target exercise, diet, and weight loss advice to obese patients and those with chronic conditions. However, the content of the advice rarely includes recommended components that could increase healthy behavior change. Understanding how patients initiate health behavior topics that prompt physicians to provide advice and assistance could lead to patient and physician interventions that increase productive health behavior change discussions.

UR - http://www.scopus.com/inward/record.url?scp=20344390285&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20344390285&partnerID=8YFLogxK

M3 - Article

C2 - 15933914

AN - SCOPUS:20344390285

VL - 37

SP - 415

EP - 421

JO - Family Medicine

JF - Family Medicine

SN - 0742-3225

IS - 6

ER -