CORRELATES OF PHYSICIAN COUNSELING ASSOCIATED WITH OBESITY AND SMOKING

Background. Patient, physician, and consultation variables associated with overweight and smoking counseling in general practice consultatio ns were examined. Methods. A random sample of full-time general practi tioners was used. The sample consisted of 7,160 patients from 230 GPs who attended for consultations on consecutive days, and self-reported information from the doctor and the patient was collected via question naire. The aim of this paper is to identify variables associated with the doctor's identification of over-weight and smoking status and with the occurrence of counseling for these two behavioral risk factors. R esults. Forty percent of patients were overweight (BMI >24) and 25% we re self-reported smokers. Doctors identified 59% of overweight patient s and 66% of smokers. Doctors only counseled patients identified as ha ving the risk factor, counseling 36% of identified overweight patients and 49% of identified smokers. Identification of overweight was assoc iated with being female, being heavier, having been previously counsel ed, being less well educated, presenting with an associated condition, and visiting a doctor who is younger and knows the patient's medical history well. Counseling for overweight was associated with being youn ger, being previously counseled, presenting with an associated conditi on, presenting for a routine checkup, visiting a GP who generally has longer consultations, having BP measured in the consultation, visiting an older doctor and visiting a doctor who considers identification of risk behaviors important. Identification of smokers was associated wi th being a heavier smoker, with those who had been previously counsele d, with marital status other than single or married, with a BP measure ment being taken in the consultation, and with a doctor who believed i t possible to influence lifestyle change. Counseling for smoking was a ssociated with younger patients, longer consultations, previous counse ling, BP measurement, presenting with an associated condition, and not presenting frequently. Conclusions. We have identified factors associ ated with counseling about behavioral risk factors which provide a fra mework for planning education programs to increase the level of primar y preventive activities within general practice. (C) 1996 Academic Pre ss, Inc.