Addressing Obesity Through Nutrition and Physical Activity Counseling: Medical and Physician Assistant Students' Counseling Attitudes and Personal Health Behaviors

摘要

Importance. Oklahoma ranks 48th highest in adult obesity, which is partly due to poor eating and physical inactivity behaviors in the state. National studies indicate that healthcare providers who personally exercise and follow a healthy diet are more likely to counsel their patients in these areas, and that patients are more receptive to this counseling when they perceive their provider practices these behaviors. Little is known about Oklahoma healthcare student attitudes towards these types of counseling, and whether their personal health habits influence their confidence to counsel. Objective. To describe Oklahoma medical and physician assistant (PA) students' personal nutrition and physical activity habits, attitudes and confidence to counsel in these areas, and whether personal habits influence counseling confidence. Design, Setting, and Participants. We invited 109 medical and 71 PA students affiliated with a midwestern medical school system to participate in a cross-sectional, anonymous electronic survey. Main Measures. Survey items assessed personal weight history, eating habits, and physical activity. Items also assessed perceptions on the importance of patient counseling on weight, physical activity, and nutrition in routine and intended medical practice, as well as general attitudes toward preventive health counseling. Results. Among respondents (n=107), over one-third (38.3%) reported weight gain since starting medical or PA school and more than one-third were currently overweight (27.1%) or obese (10.3%). Although the vast majority of students rated nutritional counseling, physical activity, weight management as very important or essential in routine medical practice, those students intending to pursue primary care found counseling in these three areas to be more personally relevant to their future practice than those intending to specialize, p < 0.05. Most students recognized the importance of provider role-modeling on patient counseling receptiveness. Students with healthier diets reported higher confidence in nutrition counseling ability, but student weight and personal physical activity were not related to counseling confidence in these areas. Conclusion and Relevance. Academic medical programs should provide students with learning environments that support healthy eating and opportunities for physical activity. Lifestyle medicine curriculum enhancements should emphasize the relevance of lifestyle and obesity counseling for all fields, including medical specialties.