National prevalence of lifestyle counseling or referral among African-Americans and whites with diabetes
Open accessAbstract
Background Modifiable risk factors such as diet and physical activity contribute to racial disparities among patients with diabetes. Despite this, little is known about how frequently physicians provide counseling or referral to address these risk factors, or whether such rates differ by patient race.Methods We analyzed cross-sectional data from the 2002-2004 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. We used logistic regression to investigate the relationship between counseling/referral for nutrition or exercise and patient factors, provider factors, and geographic location, with a focus on whether counseling rates were independently associated with patient race.Results Overall, counseling/referral for nutrition occurred in 36% of patient visits and counseling/referral for exercise occurred in 18% of patient visits. After adjusting for patient, physician, and practice characteristics, there was no statistically significant association between race and counseling/referral for nutrition (odds ratio for African-Americans compared to whites [OR] 1.00, 95% confidence intervals [CI] 0.71-1.41) or for exercise (OR 0.74, CI 0.49-1.11). Significant predictors of counseling/referral for both lifestyle interventions included younger patient age, private insurance, and treatment by a primary care provider.Conclusions Rates of lifestyle modification counseling/referral were similarly low among African-Americans and whites in this national study. Our results highlight a need for interventions to enhance physician counseling for patients with diabetes, particularly those at high-risk for diabetes-associated morbidity and mortality, such as racial/ethnic minorities.
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Physicians vary in counseling their patients to exercise: on average, advice or referral related to exercise occurred at 18% of office visits among diabetic patients, and 73% of patients reported receiving advice at some point to exercise more.
“Physicians vary in counseling their patients to exercise: on average, advice or referral related to exercise occurred at 18% of office visits among diabetic patients ( 213 ), and 73% of patients reported receiving advice at some point to exercise more ( 192 ).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [213]
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“Physicians vary in counseling their patients to exercise: on average, advice or referral related to exercise occurred at 18% of office visits among diabetic patients (213), and 73% of patients reported receiving advice at some point to exercise more (192).”
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- Authors
- Peek, M. E., Tang, H., Alexander, G. C., & Chin, M. H.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Peek, Monica E.
- Venue
- Journal of General Internal Medicine
- Published
- 2008-08-06
- Volume
- 23
- Issue
- 11
- Pages
- 1858-1864
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2585691
- OpenAlex
- W2049636515
- Cited by
- 48
- References
- 27
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 1 · 2017: 4 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 3 · 2012: 4
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- Agency for Healthcare Research and Quality (K23 DK075006, P60 DK20595, K24 DK071933, K08 HS15699-01A1, K08HS015699)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK071933, DK071933, K23DK075006, P60DK020595, P30DK092949)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- diabetes mellitus, lifestyle counseling, nutrition counseling, exercise referral, racial disparities, African Americans, health disparities, physician counseling, diet, physical activity, primary care, outpatient care
- MeSH terms
- Adolescent, Adult, Black or African American, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Outpatients, Referral and Consultation, United States, Prevalence, Odds Ratio, Health Care Surveys, Directive Counseling, Risk Reduction Behavior, White People, Diabetes Complications, Young Adult
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