UVM Theses and Dissertations
Format:
Print
Author:
Davis, Melinda
Dept./Program:
Psychology
Year:
2010
Degree:
PhD
Abstract:
Some age related declines that accompany the "normal" aging process can be attenuated through healthy lifestyle choices and preventive health behaviors. Primary care clinicians are positioned to facilitate successful aging by delivering quality medical care including health promotion counseling to patients across the lifespan. It has been proposed sed that medical clinicians' negative stereotypes about aging contribute to disparities rities in the quality of health care elders receive. This study explored the relationship between primary care clinicians' expectations regarding aging and their intended preventive counseling in response to vignettes of patients presenting to establish care. Clinician members in five practice based research networks responded to a crosssectional 2 x 2 modified factorial survey htat consisted of 4 case vignettes counterbalanced by patient age (middle versus old) and gender (male versus female), the 12-item Expectations Regarding Aging Scale (ERA-12), and descriptive questions regarding demographics, the practice setting, and clinician health behaviors. Outcome variables included clinicians' intentions to provide counseling regarding dietary habits, physical activity, and social support/activity, as well as a fourth preventive counseling composite score comprised of their mean intended counseling response. I conducted analysis for hypothesis testing across the four vignettes and by individual vignette.
Surveys were returned by 374 (24.8%) of the 1510 possible respondents, and analyses were conducted on 357. Mean respondent age was 48.64 years, 61.9% were male, 88.0% were physicians, and 96.0% specialized in family medicine. Mean scores on the ERA-12 were 67.77, with scores closer to 100 indicating respondents expected to maintain higher mental and physical functioning with aging. Clinician age was negatively correlated with ERA-12 scores, r =-0.128 (p = 0.018) and positively correlated with intended preventive counseling, r = 0.150 (p = 0.005). Clinician expectations regarding aging were positively associated with intended preventive counseling across the four vignettes for the composite score, F(1, 331) = 15.98,p <0.0001 and for the three individual items: dietary habits, X²(1, N = 336) = 8.44, p = 0.0037, physical activity, X²(1, N= 336) = 6.l7,p = 0.0130, and social support/activity, X²(1,N=336) = 12.37, p = 0.0004).
Similar patterns were found by individual vignette for the four outcome variables. Clinician age was positively associated with intended preventive counseling across the four vignettes and by individual vignette. Neither clinician gender, patient age, patient gender, nor the Patient Age x Patient Gender interaction was consistently associated with intended preventive counse'ring. Although some associations were significant, no consistent interaction pattern emerged between Clinician ERA x Patient Age and intended preventive counseling.
This study indicates that primary care clinicians with higher age-expectations report greater intention to provide preventive counseling to patients presenting to establish care regardless of individual patient factors such as age, gender, or presenting condition. These results provide insight into the attitudes and behaviors of primary care clinicians, significant others who can facilitate or deter movement toward successful aging for patients of any age. Study results may be used to inform interventions to enhance the delivery of preventive counseling across diverse primary care settings for patients across the lifespan.
Surveys were returned by 374 (24.8%) of the 1510 possible respondents, and analyses were conducted on 357. Mean respondent age was 48.64 years, 61.9% were male, 88.0% were physicians, and 96.0% specialized in family medicine. Mean scores on the ERA-12 were 67.77, with scores closer to 100 indicating respondents expected to maintain higher mental and physical functioning with aging. Clinician age was negatively correlated with ERA-12 scores, r =-0.128 (p = 0.018) and positively correlated with intended preventive counseling, r = 0.150 (p = 0.005). Clinician expectations regarding aging were positively associated with intended preventive counseling across the four vignettes for the composite score, F(1, 331) = 15.98,p <0.0001 and for the three individual items: dietary habits, X²(1, N = 336) = 8.44, p = 0.0037, physical activity, X²(1, N= 336) = 6.l7,p = 0.0130, and social support/activity, X²(1,N=336) = 12.37, p = 0.0004).
Similar patterns were found by individual vignette for the four outcome variables. Clinician age was positively associated with intended preventive counseling across the four vignettes and by individual vignette. Neither clinician gender, patient age, patient gender, nor the Patient Age x Patient Gender interaction was consistently associated with intended preventive counse'ring. Although some associations were significant, no consistent interaction pattern emerged between Clinician ERA x Patient Age and intended preventive counseling.
This study indicates that primary care clinicians with higher age-expectations report greater intention to provide preventive counseling to patients presenting to establish care regardless of individual patient factors such as age, gender, or presenting condition. These results provide insight into the attitudes and behaviors of primary care clinicians, significant others who can facilitate or deter movement toward successful aging for patients of any age. Study results may be used to inform interventions to enhance the delivery of preventive counseling across diverse primary care settings for patients across the lifespan.