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Does provider prevention orientation influence female patients'
preventive practices?
American Journal of Preventive Medicine 2000;19(2):104-110.
Greenlund KJ, Keenan NL, Anderson LA, Mandelson, MT, Newton KM, LaCroix
AZ.
Abstract
BACKGROUND: Health care provider encouragement for particular preventive behaviors
is associated with patient adherence, but it is unclear whether a provider's
overall prevention approach influences whether patients engage in recommended
preventive measures. We examined whether older women who perceived that their
health care provider encouraged a particular preventive behavior were more
likely to follow that recommendation if they also perceived that the provider
encouraged other preventive behaviors. DATA AND METHODS: The sample included
1119 women aged 50 to 79 enrolled in a health maintenance organization. We
examined associations of reported provider encouragement for post-menopausal
hormone use, physical activity, fecal occult blood testing (FOBT), and flexible
sigmoidoscopy with one another and with adherence to these measures according
to recommended guidelines. RESULTS: Among women reporting provider encouragement
for physical activity, the likelihood of reporting regular physical activity
was greater among women who reported encouragement for one other (odds ratio
[OR]=1.99; confidence interval [CI]=1.35 to 2.95) and at least two other
(OR=2. 38; 95% CI=1.62 to 3.48) preventive measures compared with women who
reported no other encouragement. The likelihood of reporting adequate counseling
for post-menopausal hormone use was greater among women reporting encouragement
for at least two other preventive measures compared with those reporting
no other encouragement. The likelihood of having had an FOBT or sigmoidoscopic
examination was related to encouragement for those procedures, but not with
greater encouragement for other preventive measures. CONCLUSIONS: Patient
perceptions of a provider's overall preventive practice approach may influence
whether patients engage in recommended preventive practices, particularly
for lifestyle factors.