Determinants of counseling in primary care pediatric practice: Physician attitudes about time, money, and health issues

Tina L Cheng, Thomas G. DeWitt, Judith A. Savageau, Karen G. O'Connor

Research output: Contribution to journalArticle

Abstract

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. 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, P

Original languageEnglish (US)
Pages (from-to)629-635
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Volume153
Issue number6
StatePublished - Jun 1999
Externally publishedYes

Fingerprint

Counseling
Primary Health Care
Pediatrics
Physicians
Health
Safety
Television
Firearms
Self Efficacy
Practice (Psychology)
Substance-Related Disorders
Pediatricians
Education

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Determinants of counseling in primary care pediatric practice : Physician attitudes about time, money, and health issues. / Cheng, Tina L; DeWitt, Thomas G.; Savageau, Judith A.; O'Connor, Karen G.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 153, No. 6, 06.1999, p. 629-635.

Research output: Contribution to journalArticle

@article{c3e49213a06d43a2918eb40bae9341ed,
title = "Determinants of counseling in primary care pediatric practice: Physician attitudes about time, money, and health issues",
abstract = "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. 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, P",
author = "Cheng, {Tina L} and DeWitt, {Thomas G.} and Savageau, {Judith A.} and O'Connor, {Karen G.}",
year = "1999",
month = "6",
language = "English (US)",
volume = "153",
pages = "629--635",
journal = "JAMA Pediatrics",
issn = "2168-6203",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Determinants of counseling in primary care pediatric practice

T2 - Physician attitudes about time, money, and health issues

AU - Cheng, Tina L

AU - DeWitt, Thomas G.

AU - Savageau, Judith A.

AU - O'Connor, Karen G.

PY - 1999/6

Y1 - 1999/6

N2 - 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. 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, P

AB - 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. 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, P

UR - http://www.scopus.com/inward/record.url?scp=0033043288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033043288&partnerID=8YFLogxK

M3 - Article

C2 - 10357306

AN - SCOPUS:0033043288

VL - 153

SP - 629

EP - 635

JO - JAMA Pediatrics

JF - JAMA Pediatrics

SN - 2168-6203

IS - 6

ER -