Determination of factors influencing the desire and possibilities of prevention of inactivity and other behavi­oral risk factors by primary care physicians (REFLECTION). The results of a one-time survey

Abstract

Aim    To evaluate clinical practice of primary care physicians with respect of preventing behavioral risk factors in patients as well as objective and subjective factors that influence their motivation for taking preventive measures. Material and methods    This study was a cross-sectional survey. The questionnaire was anonymous and included closed questions and multiple-choice questions. Based on the obtained results, prevalence of modifiable risk factors for chronic noninfectious diseases (CNID) was comprehensively evaluated in the survey population. Also, a special quantitative variable was introduced, the Index of Behavioral Risk Factors. that reflected the burden of risk factors. This composite index included the degree of risk factor in a specific respondent, for example, obesity degree, number of cigarettes smoked per day, severity of hypodynamia. Physicians’ knowledge and beliefs about the effect of physical activity (PA) on certain diseases were evaluated. Result    623 physicians (mean age 40 years (31-52), 85.5 % women) participated in the survey. The respondents included general practitioners (7.5%), cardiologists (2.9 %), preventive care physicians (4.8 %), internists (25.4 %), and other specialists (59.4 %). 70.8 % of respondents never smoked, 17.5 % were current smokers. 38.5% (240) of the surveyed had a normal body weight index (BWI); 41.7 % (260) were overweight; 11.6 % (72) had degree 1 obesity; 3.7 % (23) had degree 2 obesity; and 0.8 % had degree 3 obesity. A very low PA level was noticed; most of the surveyed exercised not more than once a week (median, 1 (0-3) time). More than 90 % had behavioral risk factors, low PA and excessive body weight. The physicians with a higher index of behavioral risk factors 50% less frequently checked the body weight of patients (odds ratio (OR), 0.541; 95 % confidence interval (CI): 0.388–0.753, p<0.05); 33% less frequently asked whether the patient smoked (OR, 0.675; 95 % CI: 0.465–0.978, p=0.037); 50% less frequently asked the patients about his/her level of PA (OR, 0.482; 95 % CI: 0.343–0.678, p<0.001); and 60% less frequently recommended increasing the PA (OR, 0.408; 95 % CI: 0.292–0.570, p<0.001).Conclusion    Most of the surveyed were aware of the benefits of PA for prevention and treatment of CNID, however, they related the mechanism of this effect only with weight loss. The most frequently mentioned barriers to behavioral risk counseling were uncertainty about whether such counseling was within the physician's professional competence, lack of time, lack of confidence in the provision of advice and the effectiveness of interventions, and lack of patients’ compliance.