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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Assessment and management of lifestyle risk factors in rural and urban general practices in Australia

Megan Passey A D , Mahnaz Fanaian B , David Lyle C and Mark F. Harris B
+ Author Affiliations
- Author Affiliations

A Northern Rivers Department of Rural Health, School of Public Health, University of Sydney, Lismore, NSW 2480, Australia.

B Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of NSW, Sydney, NSW 2052, Australia.

C Broken Hill Department of Rural Health, School of Public Health, University of Sydney, Broken Hill, NSW 2880, Australia.

D Corresponding author. Email: megan.passey@ncahs.health.nsw.gov.au

Australian Journal of Primary Health 16(1) 81-86 https://doi.org/10.1071/PY09061
Published: 17 March 2010

Abstract

Prevention of cardiovascular disease is a major public health challenge. Many chronic health problems are amenable to lifestyle interventions, which can ameliorate progression of disease and contribute to primary prevention. Prior to a large randomised controlled trial we assessed preventive care in trial practices. General practitioners and practice nurses completed a preventive care questionnaire covering frequency of assessing and managing behavioural and physiological risk factors, which was developed from previously validated instruments. Factor analysis confirmed 10 scales. Scores for rural and urban respondents were contrasted using univariate statistics. Sixty-three general practitioners and practice nurses completed the questionnaire (27 urban and 36 rural). The clinicians reported high levels of assessment and advice for cardiovascular risk factors but less frequent referral. There were no differences between urban and rural practitioners in relation to assessment of risk or stage of change, referral or barriers to referral or management of high blood pressure. Rural practitioners had lower scores for frequency of advice, and management of obesity/overweight, pre-diabetes and high lipids. Although clinicians report frequently advising high risk patients to exercise more, there remain significant gaps in provision of dietary advice and referral. Greater attention to addressing these issues is required to maximise the potential benefits for cardiovascular disease prevention in general practice.

Additional keywords: cardiovascular disease, prevention.


Acknowledgements

This paper was written on behalf of the Health Improvement and Prevention Study group and was supported by National Health and Medical Research Council Project Grant no. 455268. We would like to thank the participating practices and their staff, and the General Practice Networks of Northern Rivers, Dubbo, Central Sydney, South-Eastern Sydney and Eastern Sydney. We would also like to acknowledge the contribution of the other investigators (Associate Professor Gawaine Powell Davies, Dr Suzanne McKenzie, Dr Gaynor Heading, Professor Nick Zwar, Dr Upali Jayasinge, Dr Qing Wan, Rachel Laws, Cheryl Amoroso, Chris Tzarimas and Liz Devlin), and the research officers (Liz Rix and Emily Saurman).


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