Physical Activity Assessment and Recommendation for Adults With Arthritis by Primary Care Providers—DocStyles, 2018

In: American journal of health promotion, Volume 35, Issue 4, p. 559-570

Abstract

Purpose: To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis. Design: Cross-sectional. Setting: 2018 DocStyles online national market research survey of US physicians and nurse practitioners. Sample: 1,389 PCPs seeing adults with arthritis. Measures: 2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: "always assesses," "always recommends," and "both" ("always assesses and recommends"). Analysis: Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression. Results: Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly ("both": 56.4%; "always assesses": 66.7%; "always recommends": 71.3%) and lowest among obstetrician/gynecologists ("both": 26.9%; "always assesses": 36.8%; "always recommends": 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of "always assesses" (PR = 1.5 [95% confidence interval (CI): 1.3−1.8] and "both" (PR = 1.6 [95% CI: 1.4−1.9]). Conclusions: Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.