Table 4.
Composite Score for the Perception of the Impact Social Determinants of Health Have on Their Patient’s Health | ||||||
---|---|---|---|---|---|---|
Bivariate Analysis | Multivariate Analysis*** | |||||
N | Mean Difference (95% CI)** | P | N | Adjusted Mean Difference (95% CI)** | P | |
Perception of lifestyle medicine core competencies* | ||||||
Clinical lifestyle medicine competencies | 354 | 0.41 (0.12, 0.70) | .006 | 315 | 0.41 (0.32, 0.50) | <.001 |
Community-based lifestyle medicine competencies | 347 | 0.51 (0.35, 0.67) | <.001 | 310 | 0.51 (0.46, 0.56) | <.001 |
Use of clinical lifestyle medicine competencies | ||||||
Perform a history and physical exam specific to lifestyle-related health status | 354 | 0.15 (−0.14, 0.45) | .3 | 315 | 0.16 (0.05, 0.26) | .003 |
Order and interpret tests to screen, diagnose, and monitor lifestyle-related diseases | 354 | 0.04 (−0.26, 0.33) | .81 | 315 | 0.04 (−0.07, 0.14) | .5 |
Counsel patients using behavioral modification techniques | 354 | 0.37 (0.07, 0.67) | .02 | 315 | 0.37 (0.26, 0.47) | <.001 |
Tailor care and recommendations to the patient context | 354 | 0.38 (−0.01, 0.76) | .06 | 315 | 0.38 (0.24, 0.51) | <.001 |
Assist patients in self-managing their behavior and lifestyles using evidence-based, achievable, specific written plans | 354 | 0.32 (0.14, 0.50) | <.001 | 315 | 0.32 (0.26, 0.38) | <.001 |
Use of community-based lifestyle medicine competencies | ||||||
Use appropriate community referral resources that support the implementation of healthy lifestyles | 354 | 0.33 (0.17, 0.49) | .001 | 315 | 0.33 (0.28, 0.39) | <.001 |
Partner with public health and community-based organizations to share information, coordinate services, and build shared capacity for chronic disease prevention | 354 | 0.11 (−0.04, 0.25) | .15 | 315 | 0.11 (0.05, 0.16) | <.001 |
Advocate for policies that would improve community conditions that influence patient and population health | 354 | 0.21 (0.07, 0.36) | .004 | 315 | 0.21 (0.16, 0.26) | <.001 |
Notes: *Clinical and community-based lifestyle medicine competency factors were identified using Principal component analysis. Mean composite scores were created based on the mean of the items included in each factor. A binary variable for the perception of LM competencies was created splitting responses into those that perceived lifestyle medicine core competencies to be important/very important and less than important.
** The mean difference in composite scores is calculated as the difference in mean composite scores of family physicians’ perception of the impact social determinants of health have on their patient’s health between respondents that perceived lifestyle medicine core competencies to be important/very important and less than important, as well as respondents that practiced lifestyle medicine core competencies regularly or somewhat regularly compared to those that did not practice.
*** Multivariate analysis adjusts for gender and social deprivation index (sdi) score.