Health behaviors and patient–practitioner communication in cancer patients and the general population: an analysis of the National Health and Nutrition Examination Survey (NHANES) 2005–2014

Abstract

The purpose of the study was to investigate the prevalence of poor health behaviors (low dietary quality, low physical activity (PA), and high body mass index (BMI)) in cancer patients and the general population and its relationship with receipt of patient–physician recommendations. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2005–2014 to compare 1846 patients with a history of cancer to 16,641 with no cancer history. BMI was measured during physical exam. Dietary quality and PA were obtained from a questionnaire, along with receipt of physician recommendations for each behavior. Cancer patients had dietary quality that “needs improvement,” were not meeting PA recommendations, and were overweight. Compared to the general population, dietary quality (54 vs. 54, p\u2009=\u2009.80), prevalence of physical inactivity (34% vs. 31%, p\u2009=\u2009.01), and BMI (28 vs. 28, p\u2009<\u2009.01) were similar. Among cancer patients, prevalence of physician recommendations to improve dietary quality (33.5%), increase PA or exercise (47.7%), and lose or control weight (32.1%) were low. Physicians recommended health behavior change to cancer patients more frequently than the general population (p\u2009<\u2009.01). Overweight and physically inactive cancer patients were more likely to receive physician recommendations (ps\u2009<\u2009.01). Physician recommendations were not associated with dietary quality (p\u2009=\u2009.65). Prevalence of poor diet, physical inactivity, and obesity is high in both populations with less than 50% of patients receiving physician health behavior recommendations. These findings underscore the need for increased frequency and efficacy of patient–physician health behavior recommendations, especially in cancer patients, to improve patient outcomes.