RT Journal
A1 Wee CC, McCarthy EP, Davis RB, Phillips RS
T1 PHysician counseling about exercise
JF JAMA
JO JAMA
YR 1999
FD October 27
VO 282
IS 16
SP 1583
OP 1588
DO 10.1001/jama.282.16.1583
UL http://dx.doi.org/10.1001/jama.282.16.1583
AB Context 
                  The increase in sedentary lifestyle may contribute to the rise in obesity
nationally. Although guidelines suggest that physicians counsel all patients
about exercise, physicians counsel only a minority of their patients. Whether
patient factors influence physician counseling is not well established.Objectives 
                  To examine and to identify factors associated with exercise counseling
by US physicians.Design and Setting 
                  National population-based supplemental (Year 2000) survey to the 1995
National Health Interview Survey.Participants 
                  Of the 17,317 respondents to the Year 2000 supplemental survey, 9711
adults had seen a physician in the previous year, and 9299 responded when
asked about physician counseling on exercise.Main Outcome Measure 
                  Physician counseling to begin or to continue to exercise.Results 
                  Of 9299 respondents, 34% reported being counseled about exercise at
their last visit. After adjustment for other sociodemographic and clinical
factors, women were slightly more likely to be counseled, with an adjusted
odds ratio (AOR) of 1.15 (95% confidence interval [CI], 1.02-1.29). Physicians
counseled older patients (>30 years) more often than younger patients; those
aged 40 to 49 years were counseled most often (AOR, 1.71 [95% CI, 1.34-2.20]).
Patients with incomes above $50,000, those with higher levels of physical
activity, college graduates, and patients who were overweight to obese (body
mass index: 25 to ≥30 kg/m2) were more likely to be counseled,
as were patients with cardiac disease (AOR, 1.81 [95% CI, 1.52-2.14]) and
diabetes (AOR, 1.87 [95% CI, 1.46-2.38]). Counseling did not vary by physician
specialty or patient race.Conclusion 
                  The rate of physician counseling about exercise is low nationally. Physicians
appear to counsel as secondary prevention and are less likely to counsel patients
at risk for obesity. The failure to counsel younger, disease-free adults and
those from lower socioeconomic groups may represent important missed opportunities
for primary prevention.