Promotion of nutrition and physical activity in Dutch general practice

Introduction: Promotion of nutrition and physical activity is important to slow down the increase of overweight. General practitioners (GPs) are in an unique position to communicate with their patients about nutrition and physical activity, because of the high referral score, high perceived expertise and reach to nearly all segments of the population. Our research group has a large history in the field of nutrition guidance practices by GPs. The aim of the present study is to gain insight into the similarities and differences in patterns between nutrition and physical activity guidance practices by GPs. Methods: In 1992, a mail questionnaire (The Wageningen GPs Nutritional Practices Questionnaire) was developed and sent to a nationwide sample of 1000 Dutch GPs, who had 5- 15 years of practice experience. Altogether, 633 GPs participated. All eligible 488 participants from 1992 were asked to participate again in the 2007 study. In total, 255 GPs (in practice for 20- 30 years) returned the questionnaire. The response rate appeared to be 52%. Additionally, a new cohort of GPs was asked to fill in the questionnaire, resulting in another 217 GPs in practice for 5- 20 years. The questionnaire was developed on the basis of qualitative research. Self-reported nutrition guidance practices, task perceptions, self-efficacy expectations and perceived barriers regarding this practices were assessed in the questionnaire. In 2007, the questionnaire also included questions about physical activity guidance practices and its determinants. This makes it possible to study whether GPs, who are communicating about nutrition, are the same GPs, who communicate about physical activity. In addition, special attention has been given to literature reviews about nutrition and physical activity guidance practices by GPs. Results: Around 80% of GPs mentioned that they often noticed their patients’ weight. Our study showed that GPs are more likely to communicate with overweight patients about physical activity than about nutrition. Moreover, GPs perceived their tasks concerning physical activity guidance more preventive than their tasks concerning nutrition guidance. Also, self-efficacy for physical activity guidance appeared to be higher than for nutrition guidance. Furthermore, 71% of GPs perceived lack of time as barrier for nutrition guidance, although only 54% mentioned this as barrier for physical activity guidance. Conclusions: This study indicates that Dutch GPs are more often inclined to promote physical activity than to promote nutrition to overweight patients. Likewise, they tend to rate determinants of physical activity guidance more positively than determinants of nutrition guidance. The preliminary results of in-depth analysis of the similarities and differences between nutrition and physical activity guidance practices will be discussed at the conference