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Knowledge, Attitudes and Behaviours Related to Physician-Delivered Dietary Advice for Patients with Hypertension

Journal of Community Health volume 45, pages 1067–1072 (2020)Cite this article

Abstract

Dietary modifications are key health behaviour recommendations for the prevention and management of hypertension, a leading contributor of global disease burden. Despite this, few primary care physicians discuss nutrition with their patients. This study describes the barriers and facilitators to the provision of dietary advice for hypertension prevention and management among Canadian physicians. A validated 62-item cross-sectional survey was distributed online to 103 Canadian primary care physicians between 2017 and 2019. Eighty participants were included in the analyses. The majority of participants were based in Ontario (68.7%) and saw 10–24 patients per week (53.5%). Fewer than half (47.5%) of participants were knowledgeable about the recommended sodium level by Hypertension Canada (< 2000 mg/day) and 38.8% felt it was difficult to know which foods are high or low in sodium. Approximately one quarter felt the findings about sodium and hypertension and cardiovascular disease are controversial. Other significant barriers were: not enough time to talk to patients about diet (76.3%), belief that patients are not truthful about their diet (76.3%), patients would not follow their advice (46.8%), and that it was difficult to keep up with so many guidelines (50.0%). Many identified that electronic medical record tools (80.8%), access to dietitians (84.9%), or more nutrition education in medical training (65.8%) would help facilitate advice. Given the importance of diet and the central role of physicians in motivating dietary change among patients, approaches are required to address identified barriers and facilitators to providing dietary advice to reduce the burden of hypertension.

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Funding

This research was funded by the Heart and Stroke Foundation of Canada.

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Authors and Affiliations

  1. Faculty of Health Sciences, Ontario Tech University (University of Ontario Institute of Technology), Oshawa, ON, Canada

    Sarah Dash, Victoria Delibasic, Sadeem Alsaeed, Katherine Jefferson & JoAnne Arcand

  2. Department of Family Medicine, Queens University, Kingston, ON, Canada

    Michael Ward

  3. Department of Family Medicine, University of Alberta, Edmonton, AB, Canada

    Donna P. Manca

  4. Faculty of Health Sciences, Ontario Tech University (University of Ontario Institute of Technology), 2000 Simcoe St. North, Science Building, Rm 3016, Oshawa, ON, L1G 0C5, Canada

    JoAnne Arcand

Authors
  1. Sarah Dash
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  2. Victoria Delibasic
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  3. Sadeem Alsaeed
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  4. Michael Ward
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  5. Katherine Jefferson
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  6. Donna P. Manca
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  7. JoAnne Arcand
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Sarah Dash, Victoria Delibasic and Sadeem Alsaeed. The first draft of the manuscript was written by Sarah Dash and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to JoAnne Arcand.

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Dash, S., Delibasic, V., Alsaeed, S. et al. Knowledge, Attitudes and Behaviours Related to Physician-Delivered Dietary Advice for Patients with Hypertension. J Community Health 45, 1067–1072 (2020). https://doi.org/10.1007/s10900-020-00831-x

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  • DOI: https://doi.org/10.1007/s10900-020-00831-x

Keywords

  • Diet advice
  • Barriers and facilitators
  • Primary care
  • Hypertension
  • Counselling