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People with multiple unhealthy lifestyles are less likely to consult primary healthcare

Feng, Xiaoqi; Girosi, Federico; McRae, Ian S

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BACKGROUND Behavioural interventions are often implemented within primary healthcare settings to prevent type 2 diabetes and other lifestyle-related diseases. Although smoking, alcohol consumption, physical inactivity and poor diet are associated with poorer health that may lead a person to consult a general practitioner (GP), previous work has shown that unhealthy lifestyles cluster among low socioeconomic groups who are less likely to seek primary healthcare. Therefore, it is uncertain...[Show more]

dc.contributor.authorFeng, Xiaoqi
dc.contributor.authorGirosi, Federico
dc.contributor.authorMcRae, Ian S
dc.date.accessioned2015-12-14T22:37:44Z
dc.date.available2015-12-14T22:37:44Z
dc.identifier.issn1471-2296
dc.identifier.urihttp://hdl.handle.net/1885/95013
dc.description.abstractBACKGROUND Behavioural interventions are often implemented within primary healthcare settings to prevent type 2 diabetes and other lifestyle-related diseases. Although smoking, alcohol consumption, physical inactivity and poor diet are associated with poorer health that may lead a person to consult a general practitioner (GP), previous work has shown that unhealthy lifestyles cluster among low socioeconomic groups who are less likely to seek primary healthcare. Therefore, it is uncertain whether behavioural interventions in primary healthcare are reaching those in most need. This study investigated patterns of GP consultations in relation to the clustering of unhealthy lifestyles among a large sample of adults aged 45 years and older in New South Wales, Australia. METHODS A total of 267,153 adults participated in the 45 and Up Study between 2006 and 2009, comprising 10% of the equivalent demographic in the state of New South Wales, Australia (response rate: 18%). All consultations with GPs within 6 months prior and post survey completion were identified (with many respondents attending multiple GPs) via linkage to Medicare Australia data. An index of unhealthy lifestyles was constructed from self-report data on adherence to published guidelines on smoking, alcohol consumption, diet and physical activity. Logistic and zero-truncated negative binomial regression models were used to analyse: (i) whether or not a person had at least one GP consultation within the study period; (ii) the count of GP consultations attended by each participant who visited a GP at least once. Analyses were adjusted for measures of health status, socioeconomic circumstances and other confounders. RESULTS After adjustment, participants scoring 7 unhealthy lifestyles were 24% more likely than persons scoring 0 unhealthy lifestyles not to have attended any GP consultation in the 12-month time period. Among those who attended at least one consultation, those with 7 unhealthy lifestyles reported 7% fewer consultations than persons with 0 unhealthy lifestyles. No effect modification was observed. CONCLUSION To optimise the prevention of lifestyle-related diseases, interventions for positive behavioural change need to incorporate non-primary healthcare settings in order to reach people with multiple unhealthy lifestyles.
dc.description.sponsorshipThe research reported in this paper is a project of the Australian Primary Health Care Research Institute at the Australian National University, which is supported by a grant from the Australian Government Department of Health.
dc.format7 pages
dc.publisherBioMed Central
dc.rights© 2014 Feng et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.sourceBMC Family Practice
dc.subjectaged
dc.subjectaged, 80 and over
dc.subjectalcohol drinking
dc.subjectdiet
dc.subjectfemale
dc.subjectgeneral practice
dc.subjecthumans
dc.subjectlogistic models
dc.subjectmale
dc.subjectmiddle aged
dc.subjectnew south wales
dc.subjectpatient acceptance of health care
dc.subjectprimary health care
dc.subjectreferral and consultation
dc.subjectrisk reduction behavior
dc.subjectsedentary lifestyle
dc.subjectsmoking
dc.subjectfood habits
dc.subjectlife style
dc.titlePeople with multiple unhealthy lifestyles are less likely to consult primary healthcare
dc.typeJournal article
local.description.notesImported from ARIES.
local.identifier.citationvolume15
dcterms.dateAccepted2014-06-19
dc.date.issued2014-06-26
local.identifier.absfor111717
local.identifier.ariespublicationU3488905xPUB3840
local.publisher.urlhttp://www.biomedcentral.com/
local.type.statusPublished Version
local.contributor.affiliationFeng, Xiaoqi, School of Medicine, University of Western Sydney, Australia
local.contributor.affiliationGirosi, Federico, University of Western Sydney, Australia
local.contributor.affiliationMcRae, Ian, College of Medicine, Biology and Environment, CMBE Research School of Population Health, Australian Primary Health Care Research Institute, The Australian National University
local.identifier.essn1471-2296
local.bibliographicCitation.issue1
local.bibliographicCitation.startpage126
local.bibliographicCitation.lastpage7
local.identifier.doi10.1186/1471-2296-15-126
local.identifier.absseo920412
dc.date.updated2016-02-24T10:05:09Z
local.identifier.scopusID2-s2.0-84902943339
local.identifier.thomsonID000338360200001
CollectionsANU Research Publications

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