PEDS 409 Group 1

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SURVERY RESEARCH METHODOLOGY
Physician Advice to the Elderly About Physical
Activity

• PEDS 409 Group 1
• Nicholas Jendzjowsky
• Cameron McKnight
• Emily Motyka
• Kristen Rosichuk

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Survey Research

• Also called sample surveys
• Uses surveys to directly study the
  characteristics of populations
• Tools used in survey research are
• Interviews
• Focus groups (small group of respondents are
  interviewed and re-interviewed)
• Mail questionnaires

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Authors

• Alseny Balde- Cecil County Health Department,
  Elkton, MD.
• Jaime Figuras- Public health officer, City of
  Wilmington, DE.
• Dawn A. Hawking- Health Care Financing
  Administration, Baltimore, MD.
• John R. Miller- Network to Improve Community
  Health, Greenbelt, MD.

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Research Question

• Do Physicians counsel their elderly patients to
  exercise?
• Do patients follow their doctors' advice?
• Does it make a difference in the patient's health
  status?

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Methods

• Four hundred randomly assigned questionnaires
  were distributed to low-income senior citizens
  (65 years of age) living in public high-rise
  apartment buildings (w/o gym facilities).

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Methods

• Two Part Questionnaire
• (Adapted from Cartmel Moon, 1992 Godin
  Shephard, 1985)
• 1st demographic information 
• 2nd height, weight, general health, physician
  advice about physical activity, and type of
  physical activity performed.
• 146 Completed (36.5 completion rate)

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Statistics

• Characteristics of the elderly who were or were
  not counseled to exercise were compared using
  univariate analysis. 
• Categorical variables were assessed using
  chi-square tests.
• Continuous variables were assessed using Students
  t tests.

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Main Findings of the Study

• How Health Status was Determined
• Health risk determined by BMI, and self-reported
  health status.
• Men with a BMI of 27.8 or more and women with a
  BMI of 27.3, are considered overweight, and
  people with a BMI of 30 or more are considered
  obese.

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Main Findings of the Study

• 46.4 surveyed were overweight, (higher incidence
  for women than men, 51.2 vs. 28.9.)
• 38 of participants with college education were
  overweight, 46 with a high school education were
  overweight, and 45 of those with less than a
  high school education were overweight.
• 28 of women were obese, compared with 21 of
  men.
• 29 of White participants were obese, 19 of
  racial minority racial groups were obese.
• 30 of participants self-reported their health
  status to be poor.

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Main Findings of the Study

• Physician Counseling
• 94 had visited doctor in past year, but only
  61.6 reported receiving advice about physical
  activity.
• Mean age of those receiving physician advice was
  77.0, versus 79.2 for those who were not
  receiving advice.
• Those with a higher BMI, reported more physician
  advice on activity. ( BMI 28.7 for those
  receiving advice vs. BMI of 26.2 who did not
  receive advice.)

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Main Findings of the Study

• 3 Classifications of Physical Activity.
• Sitting Physical Activities sewing, playing
  musical instrument, knitting.
• Light Physical Activities sweeping, mopping,
  grocery shopping
• Moderate to Heavy Activities walking, cycling,
  running

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Main Findings of the Study

• The number of times per week sitting and light
  physical activities did not vary according to
  physician advice.
• Those who participated in moderate to heavy
  physical activity had received advice. Mean 4.4
  times/week for those receiving advice vs. 3.1
  times/week for those not receiving advice.

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Main Findings of the Study

• Prevalence of physician advice was higher among
  men, than women.
• Those who were married reported more advice than
  those who were single, divorced, or widowed.
• There was no difference in race or education
• for those who received advice and those who did
  not.

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Importance of the Study

• Counseling on physical activity is not offered as
  often as recommended for elderly patients.
• Physician counseling could be improved if the
  physician made a stronger effort to counsel
  patients on a more regular basis.
• Counseling should be provided to all patients,
  and should not be a result of gender or health
  status.

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Critique

• 1. SAMPLING
• Chose a limited population
• Senior citizens living in public housing
• High-rise building with low incomes
• Homogeneous study group
• The lack of a diverse population for sampling
  will result in a poor ability to generalize the
  results of the survey to the greater elderly
  population.

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Critique

• 2. SURVEY RESPONSE
• Distributed 400 surveys and received 146
  completed surveys back
• 36.5 response
• The non-responders might be part of a
  qualitatively distinct group from those who did
  respond resulting in inaccurate results
• The researchers needed to return to the buildings
  and distribute the survey again.

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Critique

• SELF-REPORTED HEALTH STATUS
• Recall errors
• Elderly may have problems with their memory
  (Alzheimer's)
• May lie on their questionnaires

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Critique

• CLARIFYING THE OBJECTIVE
• Closed-ended questions
• Survey did not specify on the amount and quality
  of counseling
• Lack of knowledge in the duration of each
  activity

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Future Research suggestions

• What do elderly populations perceive Phys. Act.
  to be?
• What the importance of Phys. Act. is?
• What is the past history of Phys. Act. in elderly
  populations and how great an effect does this
  have on present health status (rate past phys.
  act. In categories of intensity, duration and
  type)

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Future Research suggestions

• Self efficacy of elderly populations and exercise
• Physicians self efficacy on prescribing exercise
• Adherence by the elderly to phys. act.
• Did the elderly engage in phys. act. After the
  recommendation by their doctor
• Other populations?

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Other Questions Answered by Survey/ Questionnaire

• W.r.t. to this design. It could have also
• Describe
• Gather information
• No intervention
• Simple Observation
• Elderly populations perceived notion of
  importance of physical activity
• What it is elderly populations think to be
  fitness activities?

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Other Questions Answered by Survey/ Questionnaire

• Elderly populations perceived efficacy of their
  physician on this matter of physical activity
• Do the elderly think that they need to engage in
  physical activity for health purposes?

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Conclusion

• Survey or questionnaire type research seeks to
  find answer to direct questions
• Describe a certain problem
• More research is conducted to find solutions to
  the problem questioned

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Reference

• Balde, A., Figueras, J., Hawking, D.A., Miller,
  J.R. (2003) Physician Advice to the Elderly
  About Physical Activity. Journal of Aging and
  Physical Activity, 1190-8.