Journal of General Internal Medicine

, Volume 23, Issue 11, pp 1858–1864

National Prevalence of Lifestyle Counseling or Referral Among African-Americans and Whites with Diabetes

  • Monica E. Peek
  • Hui Tang
  • G. Caleb Alexander
  • Marshall H. Chin
Populations at Risk

DOI: 10.1007/s11606-008-0737-3

Cite this article as:
Peek, M.E., Tang, H., Alexander, G.C. et al. J GEN INTERN MED (2008) 23: 1858. doi:10.1007/s11606-008-0737-3

Abstract

Background

Modifiable risk factors such as diet and physical activity contribute to racial disparities among patients with diabetes. Despite this, little is known about how frequently physicians provide counseling or referral to address these risk factors, or whether such rates differ by patient race.

Methods

We analyzed cross-sectional data from the 2002–2004 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. We used logistic regression to investigate the relationship between counseling/referral for nutrition or exercise and patient factors, provider factors, and geographic location, with a focus on whether counseling rates were independently associated with patient race.

Results

Overall, counseling/referral for nutrition occurred in 36% of patient visits and counseling/referral for exercise occurred in 18% of patient visits. After adjusting for patient, physician, and practice characteristics, there was no statistically significant association between race and counseling/referral for nutrition (odds ratio for African-Americans compared to whites [OR] 1.00, 95% confidence intervals [CI] 0.71–1.41) or for exercise (OR 0.74, CI 0.49–1.11). Significant predictors of counseling/referral for both lifestyle interventions included younger patient age, private insurance, and treatment by a primary care provider.

Conclusions

Rates of lifestyle modification counseling/referral were similarly low among African-Americans and whites in this national study. Our results highlight a need for interventions to enhance physician counseling for patients with diabetes, particularly those at high-risk for diabetes-associated morbidity and mortality, such as racial/ethnic minorities.

KEY WORDS

diabetesrace & ethnicitypractice variationpatient educationdisparities

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Monica E. Peek
    • 1
    • 2
    • 3
    • 4
  • Hui Tang
    • 2
    • 3
  • G. Caleb Alexander
    • 1
    • 3
    • 4
  • Marshall H. Chin
    • 1
    • 2
    • 3
    • 4
  1. 1.Section of General Internal Medicine, Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Diabetes Research and Training CenterUniversity of ChicagoChicagoUSA
  3. 3.Center for Health and Social SciencesUniversity of ChicagoChicagoUSA
  4. 4.MacLean Center for Clinical Medical EthicsUniversity of ChicagoChicagoUSA