Am J Prev Med. 2025 Dec 26:108252. doi: 10.1016/j.amepre.2025.108252. Online ahead of print.
ABSTRACT
INTRODUCTION: Clinician advice to modify health behaviors can vary by patient race/ethnicity and sex, though prior studies are mixed and show variation over time. Research examining the role of insurance type is limited.
METHODS: The 2022 National Health Information Survey (NHIS) was analyzed in 2024 to estimate survey-weighted proportions of receiving clinician advice and associations with demographic factors among three at-risk groups: 1) adults who smoke cigarettes, 2) adults who engage in heavy drinking, and 3) adults with diabetes, hypertension, and/or obesity, who are insufficiently active.
RESULTS: In each relevant population, 47.5% received advice to quit smoking, 6.8% to decrease drinking, and 35.7% to increase physical activity. The odds of receiving advice to quit smoking were lower among Non-Hispanic (NH) Black (adjusted odds ratio (aOR) 0.68 [95%CI, 0.53-0.87]) and Hispanic adults (aOR 0.46 [95%CI, 0.30-0.69]) relative to NH White adults, and adults with no insurance (aOR 0.36 [95%CI, 0.24-0.56]) and private insurance (aOR 0.55, [95%CI, 0.39-0.77]) compared to Medicare. Men had higher odds (aOR: 2.36 [95%CI, 1.84-3.02]) of being advised to decrease drinking. Hispanic adults (aOR 1.27 [95%CI, 1.05-1.54]) had higher odds of receiving advice to increase physical activity; uninsured adults (aOR 0.51 [95%CI, 0.35-0.73]), men (aOR 0.85 [95%CI, 0.76-0.96]), and adults over 64 had lower odds. Adults aged 18-34 were the least likely to receive smoking or alcohol counseling.
CONCLUSION: Many at-risk adults do not receive clinician advice to modify relevant health behaviors. Counseling rates vary by patient demographic factors, highlighting opportunities to improve health equity in preventive care.
PMID:41456619 | DOI:10.1016/j.amepre.2025.108252