학술논문
General practitioner assessment of lifestyle risk factors for chronic disease: a cross-sectional study in urban, rural and remote South Australia.
Document Type
Article
Source
Subject
*CHRONIC disease risk factors
*LIFESTYLES
*CONFIDENCE intervals
*RURAL conditions
*CROSS-sectional method
*RISK assessment
*PHYSICAL activity
*SURVEYS
*COMPARATIVE studies
*PEARSON correlation (Statistics)
*ALCOHOL drinking
*CHI-squared test
*METROPOLITAN areas
*SMOKING
*SOCIODEMOGRAPHIC factors
*DATA analysis software
*LOGISTIC regression analysis
*ODDS ratio
*NUTRITIONAL status
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Language
ISSN
1448-7527
Abstract
Background: The assessment and management of the SNAP lifestyle risk factors (smoking, nutrition, alcohol intake and physical activity) is fundamental to primary prevention of chronic disease. This study investigates the prevalence of SNAP assessments conducted in South Australian general practice, according to patient risk profiles, and across urban, rural and remote locations. Methods: A cross-sectional population-based survey was conducted in South Australia in 2017. Survey data included information on health characteristics, lifestyle risks and general practitioner (GP) assessments for 2775 participants, aged ≥18 years, who visited a GP in the past 12 months. The main outcome measure was assessment for two or more (≥2) SNAP risks in this time. Logistic regression models were used to estimate the prevalence of ≥2 SNAP assessments by remoteness area, using the Modified Monash Model (MMM) classifications for urban (MMM), rural (MMM3-4) and remote (MMM5-6), and adjusting for sociodemographic, SNAP lifestyle risks and clinical variables. Results: Of the 2775 participants (mean age 49.1 ± 18.7 years; 52.7% women), 32% were assessed for ≥2 SNAP in the past 12 months. The adjusted prevalence of assessments was higher in rural (43.8%; 95% CI 36.4–51.2%) than urban (29.7%; 95% CI 27.2–32.2%) or remote (34.7%; 95% CI 28.4–41.0%) areas. Depending on rurality, ≥2 SNAP assessments were 2.5–3.4 times more likely among participants with existing cardiovascular disease, and two to seven times more likely among participants with three or four SNAP risk factors (P < 0.05 in all cases). Conclusion: Greater attention to GP SNAP assessments is warranted to match the prevalence of SNAP risks across South Australia. Assessment of SNAP lifestyle risk factors (smoking, nutrition, alcohol, physical activity) is fundamental to primary prevention of chronic disease. We used a cross-sectional population-based survey to examine the prevalence of SNAP assessments in South Australian general practice according to rurality. The overall prevalence was low (32%), but was higher in rural areas and among participants with existing cardiovascular disease or with multiple SNAP risk factors. Increased general practice SNAP assessments are warranted to match the level of risk across South Australia. [ABSTRACT FROM AUTHOR]