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Healthy and Fit for Prevention: The Influence of Clinician Health and Fitness on Promotion of Healthy Lifestyles During Health Supervision Visits
Helen J. Binns, MD, MPH
Department of Pediatrics, Children's Memorial Hospital, Department of Pediatrics Northwestern University, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Chicago, Illinois, St Charles County Pediatrics, Mercy Medical Group, St Louis, Missouri
Margaret M. Mueller, MD
Department of Pediatrics, Children's Memorial Hospital
Adolfo J. Ariza, MD
Department of Pediatrics, Children's Memorial Hospital, Department of Pediatrics Northwestern University, Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Chicago, Illinois, St Charles County Pediatrics, Mercy Medical Group, St Louis, Missouri
To understand the relationship between pediatricians' personal health and the delivery of pediatric preventive care, Illinois pediatricians were surveyed by mail. Responses from 387 pediatricians (55% response rate) regarding personal characteristics, their practice, and perceptions about preventive care patterns for children aged 2 through 10 years and management of overweight children were analyzed. Overall, 28% of pediatricians were healthy and fit (excellent/very good health and extremely/ very fit), 40% were either healthy or fit, and 33% were neither healthy nor fit. In logistic regression models controlling for personal and practice characteristics, healthy and fit pediatricians (vs neither healthy nor fit pediatricians) more routinely provided recommended care on child diet (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.6-6.2) and physical activity (OR, 3.2; 95% CI, 1.6-6.3) and assessed television time (OR, 4.4; 95% CI, 2.0-10.1). Pediatricians who were either healthy or fit (vs pediatricians who were neither healthy nor fit) more often assessed television time. Therefore, clinician health influenced application of preventive care.
Key Words: pediatrician • children • prevention • fitness • health care research • counseling
References
- Green M, Palfrey JS, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents. 2nd ed. Arlington, Va: National Center for Education in Maternal and Child Health; 2002.
- American Academy of Pediatrics. Guidelines for Health Supervision III. 3rd ed. Elk Grove, Ill: American Academy of Pediatrics; 1997.
- American Academy of Pediatrics Committee on Nutrition. Prevention of pediatric overweight and obesity. Pediatrics. 2003;112:424-430.[Abstract/Free Full Text]
- Galuska DA, Fulton JE, Powell EK, et al. Pediatrician counseling about preventive health topics: results from the Physicians' Practices Survey, 1998-1999. Pediatrics. 2002;109:e83.[Abstract/Free Full Text]
- Yarnall Ksh, Pollak KI, stbye T., Krause KM, Michener JL Primary care: is there enough time for prevention? Am J Public Health. 2003;93:635-641.[Abstract/Free Full Text]
- Green LW, Eriksen MP, Schor EL Preventive practices by physicians: behavioral determinants and potential intervention. Am J Prev Med. 1988;4(suppl):101-107.[Medline]
[Order article via Infotrieve]
- Lawrence RS Diffusion of the U.S. Preventive Services Task Force recommendations into practice. J Gen Intern Med. 1990;5(suppl):S99-S103.[Medline]
[Order article via Infotrieve]
- Bandura A. Principles of Behavior Modification. New York, NY: Holt, Rinehart & Winston; 1969:118-167.
- Golan M., Weizman A. Familial approach to the treatment of childhood obesity: conceptual model. J Nutr Educ. 2001;33:102-107.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hash RB, Munna RK, Vogel RL, Bason JJ Does physician weight affect perception of health advice? Prev Med. 2003;36:41-44.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Heath J., Andrews J., Kelley FJ, Sorrell J. Caught in the middle: experiences of tobacco-dependent nurse practitioners. J Am Acad Nurse Pract. 2004;16:396-401.[CrossRef][Medline]
[Order article via Infotrieve]
- Kawakami M., Nakamura S., Fumimoto H., Takizawa J., Baba M. Relation between smoking status of physicians and their enthusiasm to offer smoking cessation advice. Intern Med. 1997;36:162-165.[Web of Science][Medline]
[Order article via Infotrieve]
- Willaing I., Jorgensen T., Iversen L. How does individual smoking behaviour among hospital staff influence their knowledge of the health consequences of smoking? Scand J Public Health. 2003;31:149-155.
- Ohida T., Sakurai H., Mochizuki Y., et al. Smoking prevalence and attitudes toward smoking among Japanese physicians. JAMA. 2001;285:2643-2648.[Abstract/Free Full Text]
- Nelson DE, Giovino GA, Emont SL, et al. Trends in cigarette smoking among US physicians and nurses. JAMA. 1994;271:1273-1275.[Abstract/Free Full Text]
- Trowbridge FL, Sofka D., Holt K., Barlow SE Management of child and adolescent obesity: study design and practitioner characteristics. Pediatrics. 2002;110(pt 2): 205-209.[Abstract/Free Full Text]
- Kolagotla L., Adams W. Ambulatory management of childhood obesity. Obesity Res. 2004;12:275-283.[Web of Science][Medline]
[Order article via Infotrieve]
- Story MT, Neumark-Stzainer DR, Sherwood NE, et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002:110(pt 2);210-214.[Abstract/Free Full Text]
- Jonides L., Buschbacher V., Barlow SE Management of child and adolescent obesity: psychological, emotional, and behavioral assessment. Pediatrics. 2002;110 (pt 2): 215-221.[Abstract/Free Full Text]
- Barlow SE, Dietz WH, Klish WJ, Trowbridge FL Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians. Pediatrics. 2002;110(pt 2): 222-228.[Abstract/Free Full Text]
- Hosmer DW, Lemeshow S. Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989:135-175.
- Abramson S., Stein J., Schaufele M., Frates E., Rogan S. Personal exercise habits and counseling practices of primary care physicians: a national survey. Clin J Sport Med. 2000;10:40-48.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Rosenstock IM, Strecher VJ, Becker MH Social learning theory and the Health Belief Model. Health Educ Q. 1988;15:175-183.[Web of Science][Medline]
[Order article via Infotrieve]
- Perrin EM, Flower KB, Garrett J., Ammerman AS Preventing and treating obesity: pediatricians' self-efficacy, barriers, resources, and advocacy. Ambul Pediatr. 2005; 5:150-156.
This version was published on December
1, 2007
Clinical Pediatrics, Vol. 46, No. 9,
780-786 (2007)
DOI: 10.1177/0009922807303229
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