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dc.contributor.authorCheng, Tina L.
dc.contributor.authorDeWitt, Thomas G.
dc.contributor.authorSavageau, Judith A.
dc.contributor.authorO'Connor, Karen G.
dc.date2022-08-11T08:08:36.000
dc.date.accessioned2022-08-23T16:00:47Z
dc.date.available2022-08-23T16:00:47Z
dc.date.issued1999-06-01
dc.date.submitted2008-06-12
dc.identifier.citationArch Pediatr Adolesc Med. 1999 Jun;153(6):629-35.
dc.identifier.issn1072-4710 (Print)
dc.identifier.pmid10357306
dc.identifier.urihttp://hdl.handle.net/20.500.14038/30963
dc.description.abstractOBJECTIVES: To assess pediatrician goals and practice in preventive counseling, and to use social learning theory to examine physician attitudes about preventive health issues, time, and reimbursement to explain physician counseling behavior. DESIGN: Random sample survey of American Academy of Pediatrics fellows. PARTICIPANTS: A total of 1620 pediatricians were surveyed with a return rate of 72%. The 556 pediatricians who had finished training and who currently performed child health supervision were included. METHODS: Pediatricians were asked about their goals in 6 areas of health supervision: biomedical issues, development, behavior, family functioning, safety education, and supportive interpersonal interaction. They were also asked about the prevalence of counseling, importance of specific topics, their self-efficacy, outcome expectation in these areas, and their concerns about time and reimbursement for preventive counseling. RESULTS: Assurance of physical health and normal development were the most important goals of child health supervision among the pediatricians surveyed. Goals involving behavioral, family, and safety issues were less important and less likely to be addressed in practice. Most did not regularly discuss family stress, substance abuse, gun safety, and television. In these areas, physicians had less confidence they could provide guidance and lower expectation that they could prevent problems. Only 17% felt that they receive adequate reimbursement for preventive counseling. Most have adequate time (53%) and receive adequate respect (57%) for their preventive efforts. Physicians who were more concerned about time for preventive counseling reported less overall counseling (r = -0.28, PCONCLUSIONS: Physician goals in child health supervision were primarily biomedical, with psychosocial and safety issues of lesser importance. Concern about time for preventive counseling was associated with less reported counseling. Physician attitudes regarding the importance of a health issue and their confidence and effectiveness in counseling were more predictive of physician practice than their attitudes about time and reimbursement for preventive care.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10357306&dopt=Abstract ">Link to article in PubMed</a>
dc.relation.urlhttp://archpedi.jamanetwork.com/data/Journals/PEDS/8470/poa8426.pdf
dc.subjectAdult
dc.subject*Attitude of Health Personnel
dc.subject*Counseling
dc.subjectData Collection
dc.subjectFemale
dc.subjectGoals
dc.subject*Health Promotion
dc.subjectHumans
dc.subjectInsurance, Health, Reimbursement
dc.subjectMale
dc.subject*Pediatrics
dc.subjectPhysician's Practice Patterns
dc.subjectPrevalence
dc.subjectPreventive Medicine
dc.subjectProfessional Practice
dc.subjectQuestionnaires
dc.subjectRandom Allocation
dc.subjectRegression Analysis
dc.subjectTime Factors
dc.subjectUnited States
dc.subjectCommunity Health and Preventive Medicine
dc.subjectPreventive Medicine
dc.subjectPrimary Care
dc.titleDeterminants of counseling in primary care pediatric practice: physician attitudes about time, money, and health issues
dc.typeJournal Article
dc.source.journaltitleArchives of pediatrics and adolescent medicine
dc.source.volume153
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/fmch_articles/3
dc.identifier.contextkey523423
html.description.abstract<p>OBJECTIVES: To assess pediatrician goals and practice in preventive counseling, and to use social learning theory to examine physician attitudes about preventive health issues, time, and reimbursement to explain physician counseling behavior.</p> <p>DESIGN: Random sample survey of American Academy of Pediatrics fellows.</p> <p>PARTICIPANTS: A total of 1620 pediatricians were surveyed with a return rate of 72%. The 556 pediatricians who had finished training and who currently performed child health supervision were included.</p> <p>METHODS: Pediatricians were asked about their goals in 6 areas of health supervision: biomedical issues, development, behavior, family functioning, safety education, and supportive interpersonal interaction. They were also asked about the prevalence of counseling, importance of specific topics, their self-efficacy, outcome expectation in these areas, and their concerns about time and reimbursement for preventive counseling.</p> <p>RESULTS: Assurance of physical health and normal development were the most important goals of child health supervision among the pediatricians surveyed. Goals involving behavioral, family, and safety issues were less important and less likely to be addressed in practice. Most did not regularly discuss family stress, substance abuse, gun safety, and television. In these areas, physicians had less confidence they could provide guidance and lower expectation that they could prevent problems. Only 17% felt that they receive adequate reimbursement for preventive counseling. Most have adequate time (53%) and receive adequate respect (57%) for their preventive efforts. Physicians who were more concerned about time for preventive counseling reported less overall counseling (r = -0.28, PCONCLUSIONS: Physician goals in child health supervision were primarily biomedical, with psychosocial and safety issues of lesser importance. Concern about time for preventive counseling was associated with less reported counseling. Physician attitudes regarding the importance of a health issue and their confidence and effectiveness in counseling were more predictive of physician practice than their attitudes about time and reimbursement for preventive care.</p>
dc.identifier.submissionpathfmch_articles/3
dc.contributor.departmentDepartment of Family Medicine and Community Health
dc.source.pages629-35


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