Primary care providers' provision of therapeutic lifestyle change counseling for patients with cardiovascular risk

Cardiovascular disease is important to the U.S. healthcare system, as it constitutes a high prevalence of deaths and costs the system billions each year. In lieu of this, research directed at preventative measures is important, especially those related to therapeutic lifestyle changes (TLC). TLC represents a host of healthy behaviors, such as physical activity and healthy nutrition, that have shown to provide benefits in both preventing and managing cardiovascular diseases such as hypertension, type 2 diabetes mellitus, and dyslipidemia. While public experts have advocated for physicians to recommend not only TLC for patients at cardiovascular risk but also to help them implement such changes, research is lacking on whether this occurs. The purpose of the study was to define conceptually distinct levels of TLC counseling that physicians provide to their patients, and to test whether certain situational and physician-level variables have an effect on the level of TLC counseling provided. Case complexity, perceived patient receptiveness to TLC counseling, perceived responsibility, and self-efficacy were chosen as predictor variables. A convenience sample of 606 primary care physicians was used, and an ordinal regression was conducted to analyze the results. Results found patient receptiveness to be a significant predictor for both physical activity and diet counseling, whereas case complexity and perceived responsibility were found to be significant for diet counseling.