Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.
Methods. Latinx parents and their 6th-8th grade children were recruited from eligible middle schools in Maricopa County to participate in a larger intervention study. A sample of parent-youth dyads from the first cohort of the larger study was selected for cross-sectional analysis of baseline data in this study (n=124). Participants completed a survey requesting demographics, family meal habits, and dietary intake. Participants were asked to report annual income, education level, and number of family meals in the home in the past week. They were also asked to complete an Acculturation Rating Scale for Mexican Americans, a 6-item Household Food Security Questionnaire, and a 26-question Dietary Screener Questionnaire. Analyses were run using Spearman’s Rank Correlation test and a Chi Square test of Independence.
Results. Mean daily youth intake of FV was 2.7 ± 1.4 cup equivalents, and daily youth intake of sugars from SSBs was 8.6 ± 4.9 teaspoon equivalents per day. Fifty percent of parents reported 7 or more family meals per week, while 38.7% reported 3-6 family meals per week and 11.3% reported 2 or fewer family meals per week. There was no significant association between family meal frequency and youth FV (r=-0.154; p=0.256) or added sugar from SSBs (r=0.027; p=0.807) intake. Similarly, results from Chi Square analyses suggested there was no association between family meal frequency and parent income level (p=0.392), Mexican-oriented acculturation level (p=0.591), Anglo-oriented acculturation level (p=0.052) and food insecurity (p=0.754). In contrast, a significant association between parent education and family meal frequency was found (p=0.014).
Conclusions. Parent education may play a role in shaping family meal practices in Latinx families. More research is needed to further understand this relationship and the relationship between family meal habits and youth dietary intake.
Women with breast cancer often experience weight gain during and after treatment, significantly increasing risk for recurrence as well as all-cause mortality. Based on a growing body of evidence, meditative movement practices may be effective for weight management. First, we describe the effects of stress on factors associated with weight gain for breast cancer survivors. Then, a model is proposed that utilizes existing evidence to suggest how meditative movement supports behavioral, psychological, and neurohormonal changes that may explain weight loss. Application of the model suggests how a novel "mindful-body-wisdom" approach may work to help reduce weight for this at-risk group.