Wight, Jeff T.

Background: A 21-question Lifestyle Medicine Assessment (LMA) tool was recently developed to quickly evaluate the lifestyle medicine domains (Avoidance of Substance Use, Nutrition, Connection, Movement, and Recovery). In this study, we used the LMA tool to complete a preliminary analysis of family medicine providers, a group that is known to face challenging lifestyle demands and burnout. Objective: The primary purpose was to assess the LMA domain scores and determine if significant differences exist (among the domains). The secondary purpose was to complete a correlation matrix for the LMA domain scores to better understand the strength of the relationships (among domains). Methods: The participants were 35 family medicine providers and all completed the LMA. The maximum LMA score is 50 (each of the five domains is scored 0-10 points). Pairwise comparisons were used to determine if there were significant differences among the five domain scores (P < .05) and Pearson correlation was used to assess correlations between domains. Results: The overall LMA score was moderate (34.68 ± 6.26). The Recovery domain score (4.71 ± 2.91) was significantly lower (P < 0.01) than the other domains (Connection = 6.94 ± 2.16; Nutrition = 7.41 ± 2.00; Movement = 6.26 ± 2.94; Avoidance of Substance Use = 9.35 ± 1.28). The Avoidance of Substance Use score was significantly higher than the other domains ( P < .01). Overall, the correlation scores among the domains were weak (all r-scores were ≤0.34). Conclusions: For this group of providers, there appears to be substantial room for improvement in four of the five domains. The domain of greatest concern appears to be Recovery. The weak correlation scores suggest that domain scores tend to be independent of each other, and that assessment results are unique to the individual.

AbstractPrimary care physicians (PCPs) are commonly approached with concerns involving patient genetics. This is a challenge because most PCPs lack expertise in genetic testing compared to their genetic counselor counterparts. Currently, the recommended best practice is to refer patients for genetic testing based on cancer‐related family history questionnaires with a genetic counseling referral to discuss their results and any implications. However, the extent to which PCPs are using these questionnaires for this purpose remains poorly understood. In this cross‐sectional study, PCPs were presented with the American Cancer Society's seven recommended family history questions to determine the percentage who consider each to be an indicator for referral to a genetics specialist. Questionnaires were completed by 88 of 260 attending PCPs at a national primary care review conference. The main outcome was the percentage of PCPs who identified each question as a trigger for genetic testing. Secondary outcomes included correlations with years of practice, genetics training, and methods used to obtain patient family history. Only two of the seven questions were considered triggers by most PCPs (range, 76–83%). The remaining five had lower percentages (range, 22–55%). Years of practice did not influence the number of triggers identified (Spearman correlation coefficient test: r = 0.05, p = 0.68). Few PCPs (3.4%) felt they had good to excellent genetics training during residency. Only 44.3% had genetics specialists available for referral. Overall, low percentages of PCPs consider the American Cancer Society questions to be triggers for genetic testing referrals. Furthermore, many do not have a genetics specialist or counselor available for referral. Addressing these concerns may help PCPs understand the basics of genetic testing and use standardized questionnaires to make appropriate referrals to genetic specialists, thereby reducing inappropriate referrals and improving appointment access to this precious resource for those who truly need it.