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Canadian Family Physician logoLink to Canadian Family Physician
. 2000 Aug;46:1609–1616.

Lifestyle health risk assessment. Do recently trained family physicians do it better?

N Haley 1, B Maheux 1, M Rivard 1, A Gervais 1
PMCID: PMC2144772  PMID: 10955180

Abstract

OBJECTIVE: To determine whether recently trained family physicians were more likely to routinely assess lifestyle health risks during general medical evaluations. To document physicians' perceptions of the difficulties of lifestyle risk assessment, of medical training in that area, and of how often they saw patients with lifestyle health risks. DESIGN: Anonymous mailed survey conducted in 1995. SETTING: Family practices in the province of Quebec. PARTICIPANTS: Stratified random sample of 805 active family physicians of 1111 surveyed; 25 were ineligible or could not be located, and 281 did not respond (74.1% response rate). MAIN OUTCOME MEASURES: Proportion of physicians graduating before and after 1989 who reported routinely (with 90% or more of their patients) assessing their adult and adolescent patients during general medical evaluations for substance use, sexual risk behaviours, and history of family violence and sexual abuse. RESULTS: Except for asking about drug use, recently trained family physicians did not report better assessment of lifestyle health risks during general medical examinations than family physicians who graduated more than 10 years ago did. In both groups, routine assessment averaged 82% for tobacco use, 68% for alcohol consumption, and 20% to 40% for sexual risk behaviours. Screening for family violence and sexual abuse was rare, but more frequently reported by older women physicians. Only 20% to 40% of recent graduates rated their medical training adequate for evaluating illicit drug use, family violence, and sexual abuse. CONCLUSION: Recently trained family physicians do not assess most lifestyle risk factors any better than their more experienced colleagues.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boekeloo B. O., Marx E. S., Kral A. H., Coughlin S. C., Bowman M., Rabin D. L. Frequency and thoroughness of STD/HIV risk assessment by physicians in a high-risk metropolitan area. Am J Public Health. 1991 Dec;81(12):1645–1648. doi: 10.2105/ajph.81.12.1645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brown J. B., Lent B., Brett P. J., Sas G., Pederson L. L. Development of the Woman Abuse Screening Tool for use in family practice. Fam Med. 1996 Jun;28(6):422–428. [PubMed] [Google Scholar]
  3. Catania J. A., Binson D., Dolcini M. M., Stall R., Choi K. H., Pollack L. M., Hudes E. S., Canchola J., Phillips K., Moskowitz J. T. Risk factors for HIV and other sexually transmitted diseases and prevention practices among US heterosexual adults: changes from 1990 to 1992. Am J Public Health. 1995 Nov;85(11):1492–1499. doi: 10.2105/ajph.85.11.1492. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Ferris L. E., Tudiver F. Family physicians' approach to wife abuse: a study of Ontario, Canada, practices. Fam Med. 1992 May-Jun;24(4):276–282. [PubMed] [Google Scholar]
  5. Friedman L. S., Samet J. H., Roberts M. S., Hudlin M., Hans P. Inquiry about victimization experiences. A survey of patient preferences and physician practices. Arch Intern Med. 1992 Jun;152(6):1186–1190. doi: 10.1001/archinte.152.6.1186. [DOI] [PubMed] [Google Scholar]
  6. Ghent W. R., Da Sylva N. P., Farren M. E. Family violence: guidelines for recognition and management. Can Med Assoc J. 1985 Mar 1;132(5):541–553. [PMC free article] [PubMed] [Google Scholar]
  7. Green A. H. Child sexual abuse: immediate and long-term effects and intervention. J Am Acad Child Adolesc Psychiatry. 1993 Sep;32(5):890–902. doi: 10.1097/00004583-199309000-00002. [DOI] [PubMed] [Google Scholar]
  8. Hamberger L. K., Saunders D. G., Hovey M. Prevalence of domestic violence in community practice and rate of physician inquiry. Fam Med. 1992 May-Jun;24(4):283–287. [PubMed] [Google Scholar]
  9. Koss M. P., Koss P. G., Woodruff W. J. Deleterious effects of criminal victimization on women's health and medical utilization. Arch Intern Med. 1991 Feb;151(2):342–347. [PubMed] [Google Scholar]
  10. Lewis C. E., Freeman H. E. The sexual history-taking and counseling practices of primary care physicians. West J Med. 1987 Aug;147(2):165–167. [PMC free article] [PubMed] [Google Scholar]
  11. MacDonald N. E., Wells G. A., Fisher W. A., Warren W. K., King M. A., Doherty J. A., Bowie W. R. High-risk STD/HIV behavior among college students. JAMA. 1990 Jun 20;263(23):3155–3159. [PubMed] [Google Scholar]
  12. MacMillan H. L., Fleming J. E., Trocmé N., Boyle M. H., Wong M., Racine Y. A., Beardslee W. R., Offord D. R. Prevalence of child physical and sexual abuse in the community. Results from the Ontario Health Supplement. JAMA. 1997 Jul 9;278(2):131–135. [PubMed] [Google Scholar]
  13. Maheux B., Haley N., Rivard M., Gervais A. STD risk assessment and risk-reduction counseling by recently trained family physicians. Acad Med. 1995 Aug;70(8):726–728. doi: 10.1097/00001888-199508000-00018. [DOI] [PubMed] [Google Scholar]
  14. Poulin C., Webster I., Single E. Alcohol disorders in Canada as indicated by the CAGE questionnaire. CMAJ. 1997 Dec 1;157(11):1529–1535. [PMC free article] [PubMed] [Google Scholar]
  15. Rosen M. A., Logsdon D. N., Demak M. M. Prevention and health promotion in primary care: baseline results on physicians from the INSURE Project on Lifecycle Preventive Health Services. Prev Med. 1984 Sep;13(5):535–548. doi: 10.1016/0091-7435(84)90022-7. [DOI] [PubMed] [Google Scholar]
  16. Schwartz J. S., Lewis C. E., Clancy C., Kinosian M. S., Radany M. H., Koplan J. P. Internists' practices in health promotion and disease prevention. A survey. Ann Intern Med. 1991 Jan 1;114(1):46–53. doi: 10.7326/0003-4819-114-1-46. [DOI] [PubMed] [Google Scholar]
  17. Valente C. M., Sobal J., Muncie H. L., Jr, Levine D. M., Antlitz A. M. Health promotion: physicians' beliefs, attitudes, and practices. Am J Prev Med. 1986 Mar-Apr;2(2):82–88. [PubMed] [Google Scholar]
  18. Ward J., Sanson-Fisher R. Prevalence and detection of HIV risk behavior in primary care: implications for clinical preventive services. Am J Prev Med. 1995 Jul-Aug;11(4):224–230. [PubMed] [Google Scholar]
  19. Wechsler H., Levine S., Idelson R. K., Rohman M., Taylor J. O. The physician's role in health promotion--a survey of primary-care practitioners. N Engl J Med. 1983 Jan 13;308(2):97–100. doi: 10.1056/NEJM198301133080211. [DOI] [PubMed] [Google Scholar]
  20. Wechsler H., Levine S., Idelson R. K., Schor E. L., Coakley E. The physician's role in health promotion revisited--a survey of primary care practitioners. N Engl J Med. 1996 Apr 11;334(15):996–998. doi: 10.1056/NEJM199604113341519. [DOI] [PubMed] [Google Scholar]
  21. Wenrich M. D., Curtis J. R., Carline J. D., Paauw D. S., Ramsey P. G. HIV risk screening in the primary care setting. Assessment of physicians skills. J Gen Intern Med. 1997 Feb;12(2):107–113. doi: 10.1046/j.1525-1497.1997.00015.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

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