Physicians' discussions about body weight, healthy diet, and physical activity with overweight or obese elderly patients

OBJECTIVE

To investigate the correlates of physician-patient discussions about body weight, healthy diet, and physical activity.

METHOD

Subjects were 635 adults (≥65 years; mean 72.8 years) who had an increased body mass index (BMI≥25 kg/m2) and participated in a self-administered community survey. Logistic regression analyses were performed.

RESULTS

While approximately half of study participants reported having discussed healthy diets (51%) and physical activity (52%) with their physician, only 42% of those who were overweight or obese reported being recognized as such by their physician. Being moderately or severely obese, more chronic conditions, and more frequent physician visits increased the likelihood of being recognized as overweight or obese and reporting lifestyle discussions.

DISCUSSION

The health care provider is important in recognizing older patient's weight problems and discussing practical lifestyle changes. Tools for more proactive screening and implementation of follow-up behavioral counseling can help the health care providers better address obesity prevention in clinical practice.

Effectiveness of nurse practitioner coordinated team group visits for type 2 diabetes in medically underserved Appalachia

PURPOSE

To study the effectiveness of multidisciplinary nurse practitioner coordinated team (NPCT) group visits in medically underserved Appalachia on the health, knowledge, and self-efficacy of patients with type 2 diabetes (DM). The study also identified perceived barriers to participating in the diabetes programs.

DATA SOURCES

A researcher-developed tool was used to assess demographic data, clinical data, and barriers to care. The participants completed the Diabetes Knowledge Tests and the Diabetes Empowerment Scales. Two groups were assessed. One group participated in the diabetes intervention, and the other received usual care. Both groups completed the instruments prior to the intervention and after the intervention was completed.

CONCLUSIONS

The group that participated in the intervention had better clinical outcomes (blood glucose and A1Cs), greater knowledge, and better self-efficacy following the intervention than the usual care groups. This suggests that the intervention was important in improving outcomes of patients with type 2 DM. Barriers to care included fuel, time, family, work, and transportation. Barriers need to be addressed in order to have more patients participate in such programs.

IMPLICATIONS FOR PRACTICE

NPCT group visits may represent an effective means of integrating diabetes self-management education and medical management in a family practice clinic in medically underserved areas.