Canadian Journal of Public Health

, Volume 101, Issue 5, pp 390–395 | Cite as

Predictors of Canadian Physicians’ Prevention Counseling Practices

  • Erica FrankEmail author
  • Carolina Segura
  • Hui Shen
  • Erica Oberg
Quantitative Research



To understand predictors of Canadian physicians’ prevention counseling practices.


A national mailed survey of a random sample of Canadian physicians conducted November 2007-May 2008.


Primary care physicians (n=3,213) responded to the survey (41% response rate); those with better personal health habits, female physicians, and physicians aged 45–64 years old were more likely to report “usually/always” counseling patients than did others, but there were no significant differences by province, origin of one’s MD degree, or practice location. There was a clear and consistent relationship between personal and clinical prevention practices: non-smokers were significantly more likely to report counseling patients on smoking cessation; those who drank alcohol less frequently, drank lower quantities or binged less often were more likely to counsel on alcohol; those exercising more to counsel patients more about exercise; those eating more fruits and vegetables to counsel patients more often about nutrition; and those with lower weight were more likely to counsel about nutrition, weight or exercise. Physicians who strongly agreed or agreed that “they will perform better counseling if they have healthy habits” averaged higher rates of counseling (p<0.001).


Personal characteristics of Canadian physicians help predict prevention counseling. These data suggest that by encouraging physicians to be healthy, we can improve healthy habits among their patients–an innovative, beneficent, evidence-based approach to encouraging physicians to counsel patients about prevention.

Key words

Physician health health education counseling patient counseling Canada prevention 



Connaître les prédicteurs du counseling en prévention offert par les médecins canadiens.


Sondage postal national mené entre novembre 2007 et mai 2008 auprès d’un échantillon aléatoire de médecins canadiens de premier recours.


Quarante-et-un p. cent des médecins contactés (n=3213) ont répondu au questionnaire. Les répondants ayant de meilleures habitudes de santé, les femmes et les répondants de 45 à 64 ans avaient plus tendance à conseiller leurs patients « habituellement/toujours », mais il n’y avait pas de différences significatives selon la province, l’origine du diplôme de médecine ou le lieu d’exercice. Le lien entre les habitudes personnelles et les pratiques de prévention clinique était clair et systématique: les non-fumeurs avaient significativement plus tendance à conseiller l’arrêt du tabac à leurs patients; les répondants dont la consommation d’alcool était plus faible, moins fréquente ou moins sujette aux excès occasionnels étaient plus susceptibles d’offrir des conseils sur l’alcool; ceux qui faisaient davantage d’exercice physique avaient plus tendance à donner des conseils sur l’exercice physique; ceux qui mangeaient davantage de fruits et légumes avaient plus tendance à donner des conseils de nutrition; et ceux qui n’étaient pas en surpoids avaient plus tendance à donner des conseils sur la nutrition, le poids ou l’exercice physique. Les médecins qui étaient d’accord ou tout à fait d’accord avec l’énoncé « leurs conseils seront meilleurs s’ils ont eux-mêmes de saines habitudes » affichaient en moyenne de taux de counseling supérieurs (p<0,001).


Les caractéristiques personnelles des médecins canadiens sont des prédicteurs du counseling en prévention. En incitant les médecins à être en bonne santé, il serait possible d’améliorer les habitudes de santé de leurs patients. C’est une approche novatrice, bénéfique et éprouvée pour encourager les médecins à donner des conseils de prévention aux patients.

Mots clés

médecins; santé éducation sanitaire conseil counseling du patient Canada prévention 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Health Canada 2009. Maintaining Healthy Habits. Available at: (Accessed September 13, 2009).
  2. 2.
    Centers for Disease Control and Prevention 2009. Healthy Living. Available at: (Accessed September 13, 2009).
  3. 3.
    Levi J, Vinter S, St. Laurent R, Segal LM. F as in Fat: How obesity policies are falling in America. Trust for America’s Health August 2008. (Accessed February 19, 2009).Google Scholar
  4. 4.
    Centers for Disease Control and Prevention. Obesity: Halting the Epidemic by Making Health Easier: At A Glance 2009. Available at: (Accessed February 19, 2009).
  5. 5.
    Health Canada 2009. Nutrition Labelling. Available at: (Accessed February 19, 2009).
  6. 6.
    Siedentop DL. National plan for physical activity: Education sector. J Phys Act Health 2009;6(2):168–80.CrossRefGoogle Scholar
  7. 7.
    Frank E. Physician health and patient care. JAMA 2004;291(5):637.CrossRefGoogle Scholar
  8. 8.
    Frank E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians’ prevention-related practices. Arch Fam Med 2000;9:359–67.CrossRefGoogle Scholar
  9. 9.
    Frank E, Elon E, Carrera JS, Hertzberg VS. Predictors of US medical students’ prevention counseling practices. Prev Med 2007;44(1):76–81.CrossRefGoogle Scholar
  10. 10.
    Frank E, Breyan J, Elon L. Physician disclosure of healthy personal behaviors improves credibility and ability to motivate. Arch Fam Med 2000;9(3):287–90.CrossRefGoogle Scholar
  11. 11.
    Rafferty M, Frank E. Office-based prevention: How can we make it happen? West J Med 1994;161(2):190–91.PubMedPubMedCentralGoogle Scholar
  12. 12.
    National Center for Chronic Disease Prevention and Health Promotion. Behavioral Risk Factor Surveillance System. Prevalence Data: Nationwide 2002.Google Scholar
  13. 13.
    National Institute of Alcohol Abuse and Alcoholism 2004. Binge Drinking Defined: National Institutes of Health, 2004.Google Scholar
  14. 14.
    Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 1985;10(3):141–46.PubMedGoogle Scholar
  15. 15.
    Frank E, McLendon L, Elon L, Denniston M, Fitzmaurice D, Hertzberg V. Medical students’ self-reported typical counseling practices are similar to those assessed using Standardized Patients. Medscape Gen Med 2005;7(1):2.Google Scholar
  16. 16.
    SAS Institute Inc. SAS Online Doc. Cary, NC: SAS Institute, 1999.Google Scholar
  17. 17.
    Ma J, Urizar GGJr, Alehegn T, Stafford RS. Diet and physical activity counseling during ambulatory care visits in the United States. Prev Med 2004;39(4):815–22.CrossRefGoogle Scholar
  18. 18.
    Mosca L, Linfante AH, Benjamin EJ, Berra K, Hayes SN, Walsh BW, et al. National study of physician awareness and adherence to cardiovascular disease prevention guidelines. Circulation 2005;111(4):499–510.CrossRefGoogle Scholar
  19. 19.
    Stafford RS, Farhat JH, Misra B, Schoenfeld DA. National patterns of physician activities related to obesity management. Arch Fam Med 2000;9(7):631–38.CrossRefGoogle Scholar
  20. 20.
    Hanks H, Veitch P, Harris M. A rural/urban comparison of the roles of the general practitioner in colorectal cancer management. Aust J Rural Health 2008;16(6):376–82.CrossRefGoogle Scholar
  21. 21.
    Pathman DE, Williams ES, Konrad TR. Rural physician satisfaction: Its sources and relationship to retention. J Rural Health 1996;12(5):366–77.CrossRefGoogle Scholar
  22. 22.
    Frank E, Harvey L. Prevention advice rates of women and men physicians in primary care and other disciplines. Arch Fam Med 1996;5:215–19.CrossRefGoogle Scholar
  23. 23.
    Roter D, Hall J, Aoki Y. Physician gender effects in medical communication: A meta-analytic review. JAMA 2002;288:756–64.CrossRefGoogle Scholar
  24. 24.
    Bertakis KD. The influence of gender on the doctor-patient interaction. Patient Educ Couns 2009;76(3):356–60.CrossRefGoogle Scholar
  25. 25.
    Fleming P, Godwin M. Lifestyle interventions in primary care: Systematic review of randomized controlled trials. Can Fam Phys 2008;54(12):1706–13.Google Scholar
  26. 26.
    Wright S, Wong A, Newill C. The impact of role models on medical students. J Gen Intern Med 1997;12(1):53–56.CrossRefGoogle Scholar
  27. 27.
    Baernstein A, Oelschlager AM, Chang TA, Wenrich MD. Learning professionalism: Perspectives of preclinical medical students. Acad Med 2009;84(5):574–81.CrossRefGoogle Scholar
  28. 28.
    Wranik DW, Durier-Copp M. Physician remuneration methods for family physicians in Canada: Expected outcomes and lessons learned. Health Care Anal 2009;18(1):35–59.CrossRefGoogle Scholar
  29. 29.
    Lurie N, Moscovice IS, Finch M, Christianson JB, Popkin MK. Does capitation affect the health of the chronically mentally ill? Results from a randomized trial. JAMA 1992;267(24):3300–4.CrossRefGoogle Scholar
  30. 30.
    Lurie N, Christianson J, Finch M, Moscovice I. The effects of capitation on health and functional status of the Medicaid elderly. A randomized trial. Ann Intern Med 1994;120(6):506–11.CrossRefGoogle Scholar
  31. 31.
    Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am J Health Syst Pharm 2008;65(23):2276–84.CrossRefGoogle Scholar
  32. 32.
    Dekkers JC, van Wier MF, Hendriksen IJ, Twisk JW, van Mechelen W. Accuracy of self-reported body weight, height and waist circumference in a Dutch overweight working population. BMC Med Res Methodol 2008;28(8):69.CrossRefGoogle Scholar
  33. 33.
    Corder K, van Sluijs EM, Wright A, Whincup P, Wareham NJ, Ekelund U. Is it possible to assess free-living physical activity and energy expenditure in young people by self-report? Am J Clin Nutr 2009;89(3):736–37.CrossRefGoogle Scholar
  34. 34.
    Canadian Institute for Health Information. Understanding the Physician Labour Market: Results of the 2004 National Physician Survey. Available at: (Accessed September 24, 2008).
  35. 35.
    Duperly J, Lobelo F, Segura C, Sarmiento F, Herrera D, Sarmiento OL, et al. The association between Colombian medical students’ healthy personal habits and a positive attitude toward preventive counseling: Cross-sectional analyses. BMC Public Health 2009;9:218.CrossRefGoogle Scholar
  36. 36.
    Frank E, Elon L, Hertzberg V. A Quantitative assessment of a 4-year intervention that improved patient counseling through improving medical student health. Med Gen Med 2007;9(2):58.Google Scholar
  37. 37.
    Frank E, Smith D, Fitzmaurice D. A description and qualitative assessment of a 4 year intervention to improve medical student health. Med Gen Med 2005;7(2):4.Google Scholar

Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • Erica Frank
    • 1
    • 2
    Email author
  • Carolina Segura
    • 1
  • Hui Shen
    • 1
  • Erica Oberg
    • 3
  1. 1.School of Population and Public Health, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Family Practice in the Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  3. 3.School of Public Health and Community MedicineUniversity of WashingtonSeattleCanada

Personalised recommendations