Survey of health attitudes and behaviors of a chiropractic college population

Mental health and lifestyle behaviors of students in a doctor of chiropractic program

OBJECTIVE

Health professional students' mental health and lifestyle behaviors may impact their personal health as well as their clinical practice. The objective of our retrospective study was to see if there were changes in students' mental health and lifestyle behaviors during their doctor of chiropractic program (DCP).

METHODS

In 2019, we identified health center files for 198 students who graduated from our DCP between 2015 and 2016, of which 69% (n = 137) contained Health Insurance Portability and Accountability Act (HIPAA) consent forms granting permission for file review. From each of these files, we extracted mental health and lifestyle behavior data that students self-reported at the beginning and end of their DCP. Data were analyzed with descriptive statistics, paired t test, sign test, and McNemar's chi-square test.

RESULTS

The majority of our students reported drinking alcohol, engaging in regular exercise, and not smoking at the beginning and end of our DCP. Comparing pre and post data, there was a statistically significant increase in water, fruit, and vegetable consumption along with an increased proportion of students reporting eating junk food and drinking 1 or more servings of caffeine (p ≤ .002). The proportion of students reporting anxiety or depression decreased between the beginning and end of our DCP (p = .002).

CONCLUSION

This study provided information about student mental health and lifestyle behaviors at 1 DCP. We recommend future studies use validated questionnaires across multiple DCPs. There also may be a need for intervention research to decrease DCP student alcohol use.

Are doctors and nurses engaging in physical activity and its promotion?

BACKGROUND

Physical activity counselling in health care is inadequate but the reasons for this are not well understood.

AIMS

To evaluate physical activity participation and counselling perceptions and practices among doctors and nurses in the UK.

METHODS

This study used two anonymised online questionnaires distributed at different times to doctors and nurses throughout the UK.

FINDINGS

629 responses were obtained; 78.3% of doctors and 73.4% of nurses met the UK guideline for aerobic physical activity. Perceived importance of counselling on physical activity was high but less than 50% of participants were actually providing counselling. Counselling was more likely in primary care and doctors were marginally more likely than nurses to counsel.

CONCLUSION

Doctors and nurses are an active cohort and view counselling on physical activity as important. Despite this, counselling levels are low especially in secondary care. Efforts should be made to improve knowledge and opportunity for physical activity counselling.

Influence of cooking skills and nutritional training on dietary choices of incoming chiropractic students

OBJECTIVE

We aimed to identify chiropractic students' cooking skills, perceptions of healthy eating, and influence of prior nutrition training on dietary intake.

METHODS

Two cohorts of incoming graduate students were surveyed to assess nutritional training prior to matriculation, perceptions of healthy eating behaviors, cooking skills, current dietary intake, and barriers to healthy eating. Using independent t tests, correlations, and descriptive statistics, data from the cohorts were assessed.

RESULTS

The response rate was 88.7% (n = 178). Nutritional training significantly increased perception of nutritional knowledge and confidence in giving nutrition advice. Completion of at least 1 college nutrition course was associated with nearly double students' weekly fatty fish intake. Males were more likely to eat animal protein, and females preferred desserts. Modeling a healthy diet for future patients was rated as being important, yet most students consumed diets consistent with the typical American diet. The leading barriers to healthy eating included lack of time and money.

CONCLUSION

Similar to students in other healthcare professions, incoming chiropractic students wish to model healthy behaviors but fail to apply their knowledge and attitudes to their own dietary intakes due to common barriers.

Non-response to (statin) therapy: the importance of distinguishing non-responders from non-adherers in pharmacogenetic studies

PURPOSE

In pharmacogenetic research, genetic variation in non-responders and high responders is compared with the aim to identify the genetic loci responsible for this variation in response. However, an important question is whether the non-responders are truly biologically non-responsive or actually non-adherent? Therefore, the aim of this study was to describe, within the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), characteristics of both non-responders and high responders of statin treatment in order to possibly discriminate non-responders from non-adherers.

METHODS

Baseline characteristics of non-responders to statin therapy (≤10 % LDL-C reduction) were compared with those of high responders (>40 % LDL-C reduction) through a linear regression analysis. In addition, pharmacogenetic candidate gene analysis was performed to show the effect of excluding non-responders from the analysis.

RESULTS

Non-responders to statin therapy were younger (p = 0.001), more often smoked (p < 0.001), had a higher alcohol consumption (p < 0.001), had lower LDL cholesterol levels (p < 0.001), had a lower prevalence of hypertension (p < 0.001), and had lower cognitive function (p = 0.035) compared to subjects who highly responded to pravastatin treatment. Moreover, excluding non-responders from pharmacogenetic studies yielded more robust results, as standard errors decreased.

CONCLUSION

Our results suggest that non-responders to statin therapy are more likely to actually be non-adherers, since they have more characteristics that are viewed as indicators of high self-perceived health and low disease awareness, possibly making the subjects less adherent to study medication. We suggest that in pharmacogenetic research, extreme non-responders should be excluded to overcome the problem that non-adherence is investigated instead of non-responsiveness.

The Evidence in Support of Physicians and Health Care Providers as Physical Activity Role Models

Physical inactivity constitutes the fourth leading cause of death worldwide. Health care providers (HCPs) should play a key role in counseling and appropriately referring their patients to adopt physical activity (PA). Previous reports suggest that active HCPs are more likely to provide better, more credible, and motivating preventive counseling to their patients. This review summarizes the available evidence on the association between HCPs' personal PA habits and their related PA counseling practices. Based on relevant studies, a snowball search strategy identified, out of 196 studies screened, a total of 47 pertinent articles published between 1979 and 2012. Of those, 23 described HCPs' PA habits and/or their counseling practices and 24 analytic studies evaluated the association between HCPs' personal PA habits and their PA counseling practices. The majority of studies came from the United States (n = 33), and 9 studies included nonphysicians (nurses, pharmacists, and other HCPs). PA levels were mostly self-reported, and counseling was typically assessed as self-reported frequency or perceived self-efficacy in clinical practice. Most (19 out of 24) analytic studies reported a significant positive association between HCPs' PA habits and counseling frequency, with odds ratios ranging between 1.4 and 5.7 (P < .05), in 6 studies allowing direct comparison. This review found consistent evidence supporting the notion that physically active physicians and other HCPs are more likely to provide PA counseling to their patients and can indeed become powerful PA role models. This evidence appears sufficient to justify randomized trials to determine if adding interventions to promote PA among HCPs, also results in improvements in the frequency and quality of PA preventive counseling and referrals, delivered by HCPs, to patients in primary care settings. Future studies should also aim at objectively quantifying the effect of HCPs' PA role-modeling and how it influences patients' PA levels. More evidence from low-to-middle income countries is needed, where 80% of the deaths due to inactivity and related noncommunicable diseases already occur.

Familiarity with and advocacy of Healthy People 2010 goals by Mississippi Chiropractic Association members

OBJECTIVE

The purpose of this study was to determine the familiarity with and stated advocacy of Healthy People 2010 objectives by member doctors of the Mississippi Chiropractic Association.

METHODS

Peer experts established face validity of a questionnaire regarding the Leading Health Indicators. This survey was distributed to 157 Mississippi Chiropractic Association members in 2009 during a conference and a follow-up by postal mail.

RESULTS

Most doctors of chiropractic in the sample (n = 68, or 43% response) consider themselves wellness-oriented health care providers. Forty-two percent had read, 29% had not read, and another 29% were unsure whether they had read the Healthy People 2010 national objectives. Almost half (44%) strongly or somewhat agreed that their office practice reflects support for the Healthy People 2010 objective. In contrast, 27% disagree and 29% were unsure if their practice reflects the Healthy People 2010 objectives. There were differences between support and practice behaviors for some of the objectives. Chiropractors who have read the objectives tend to be more supportive of the national goals. Doctors of chiropractic in this sample are supportive of most Leading Health Indicators, and the majority reports that they incorporate these public health goals into their practices.

CONCLUSION

Familiarity with reading the Health People objectives seems to be related to reported practice behaviors. There is a need to improve the percentage of practicing doctors of chiropractic who are familiar with Healthy People objectives. Future health education initiatives may assist doctors of chiropractic in further incorporating public health objectives into their practice behaviors and improving quality health care.