Physician gender and lifestyle counselling to prevent cardiovascular disease: a nationwide representative study

https://doi.org/10.4081/jphr.2015.534
  • Katharina Diehl | Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty, Mannheim, Germany.
  • Dirk GansefortDepartment of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS GmbH, Bremen, Germany.
  • Raphael M. HerrMannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty, Mannheim, Germany.
  • Tatiana GörigMannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty, Mannheim, Germany.
  • Christina BockMannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty, Mannheim, Germany.
  • Manfred MayerInternistic Group Practice Dr. med. Manfred Mayer und Dr. med. Angela Schmid, Mannheim; Physician Network Ärztenetz Qu@linet e.V, Mannheim, Germany.
  • Sven SchneiderMannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty, Mannheim, Germany.

ABSTRACT

Background. Primary care physicians (PCPs) have a key role in the prevention of cardiovascular diseases (CVD). However, it is not clear whether lifestyle counselling behaviour differs between female and male PCPs. Nonetheless, this information might be helpful to develop need-based advanced training for female and male PCPs. Therefore, our aim was to identify potential gender differences in the implementation of health promotion and the prevention of CVD in primary care.
Design and Methods. In a Germany-wide survey called the ÄSP-kardio Study, we collected data from 4074 PCPs (40% female; from October 2011 to March 2012). We compared the provision of prevention measures, the attitude towards counselling, and the potential barriers in counselling among female and male German PCPs. We used chi2 tests, Mann-Whitney U tests, and logistic regression analysis.
Results. We found differences in all of the above-mentioned aspects. Female PCPs were less likely to perceive barriers than male and more likely to ask patients about lifestyle, for example, nutrition (OR=1.62, P≤0.001). Additionally, female PCPs were more likely to feel well prepared (84.2% vs. 76.0%, P≤0.001) and successful (75.6% vs. 68.0%, P≤0.001). Male PCPs were more likely to mention barriers in daily practice that hinder lifestyle counselling.
Conclusions. Overall, both female and male PCPs had a positive attitude towards lifestyle counselling. Nevertheless, in view of the barriers that they indicated, incentives such as better reimbursement may help output-oriented PCPs to translate their positive attitude into action. Moreover, awareness of gender differences may help PCPs to acquire the specific advanced training that they need for effective lifestyle counselling in CVD.