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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

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2018 Impact Factor: 1.847

Front. Med.    2015, Vol. 9 Issue (2) : 251-259    https://doi.org/10.1007/s11684-015-0393-z
RESEARCH ARTICLE
Attitude toward preventive counseling and healthy practices among medical students at a Colombian university
Luz Helena Alba1(), Nora Badoui1, Fabián Gil2
1. Department of Preventive and Social Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
2. Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
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Abstract

Unhealthy behaviors of medical students influence their attitudes toward preventive counseling. The burden of chronic diseases is continually growing in developing countries, emphasizing the need for the increased role of general practitioners in preventive counseling. The objective of this study was to describe the effect of medical training on the risk profiles and attitudes of medical students toward preventive counseling in a Colombian university. Students in their first and fifth years of training were surveyed using the “Healthy Doctor= Healthy Patient” questionnaire to assess counseling attitudes; personal practices, such as risky drinking, smoking, inadequate nutrition, and non-compliance with physical activity recommendations; and the university environment. The association among these components was estimated, as well as the effect of the university environment. Risky drinking and smoking decreased from first to fifth year (59.3% vs. 37.1%, P = 0.021 and 31.5% vs. 25.9%, P = 0.51, respectively), whereas inadequate nutrition and non-compliance with physical activity recommendations increased. Physical activity (PA) was associated with positive counseling attitude (ORs: nutrition 7.6; alcohol 5.2; PA 10.6). Areas governed by institutional policies that are emphasized in the curriculum positively affected student practices. PA promoted preventive counseling and healthy lifestyles most effectively. Universities should therefore strengthen their preventive medicine curricula and modify social determinants.

Keywords lifestyle      medical students      preventive medicine      counseling      universities      schools      medical     
Corresponding Author(s): Luz Helena Alba   
Just Accepted Date: 26 March 2015   Online First Date: 28 April 2015    Issue Date: 22 May 2015
 Cite this article:   
Luz Helena Alba,Nora Badoui,Fabián Gil. Attitude toward preventive counseling and healthy practices among medical students at a Colombian university[J]. Front. Med., 2015, 9(2): 251-259.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-015-0393-z
https://academic.hep.com.cn/fmd/EN/Y2015/V9/I2/251
First year (n = 54)Fifth year (n = 54)P
Age (average)a18.322.2<0.001
Sex (%)bMale48.142.60.63
Female51.957.4
Socio-economic status (%)cLow03.70.34
Middle59.353.7
High40.742.6
BMI (Body mass index) (%)dLow7.49.30.53
Normal85.279.6
Overweight5.611.1
Obesity1.80
Health status perception (%)eGood98.294.40.02
Moderate1.85.6
Bad00
Tab.1  Student characteristics
First year students (%)Fifth year students (%)P
Nutrition
>5 servings of fruits and vegetables57.40<0.001
3 − 4 servings of fruits and vegetables16.70
0 − 2 servings of fruits and vegetables25.9100
Smoking
Non-smoker68.574.10.51
Smokes 10 or less cigarettes/day27.825.9
Smokes 11 or more cigarettes/day3.70
Alcohol
Non-risky consumption40.762.90.021
Risky consumption59.337.1
Physical activity
Compliance with recommendation46.325.90.014
Mildly activea07.4
Sedentaryb53.766.7
Perceived barriers
Physical activity
Lack of time8785.20.99
Lack of energy55.668.50.12
Lack of social support27.838.90.31
Fruit and vegetable consumption
Difficult access1316.70.4
High cost5.616.70.06
Dislike of fruits13130.61
Dislike of vegetables29.622.20.25
Tab.2  Prevalence of risk factors and perceived barriers for healthy behavior
FavorableUnfavorableIndifferent
Opinions of fifth year students toward the role of faculty in risk factor prevention [% (95% CI)]
Nutrition20.4 (11.4 – 33.6)46.3 (33.2 – 60.0)33.3 (21.8 – 47.3)
Smoking57.4 (43.6 – 70.2)22.2 (12.8 – 35.7)20.4 (11.4 – 33.6)
Alcohol22.2 (12.8 – 35.7)40.7 (28.2 – 54.6)37.0 (25.0 – 51.0)
Physical activity14.8 (7.4 – 27.4)59.3 (45.4 – 71.8)25.9 (15.7 – 39.6)
Opinions of fifth year students toward preventive medicine curriculum [% (95% CI)]
Nutrition20.4 (11.4 – 33.6)59.3 (45.4 – 71.8)20.4 (11.4 – 33.6)
Smoking75.9 (62.3 – 85.7)5.6 (1.7 – 16.4)18.5 (10.1 – 31.6)
Alcohol53.7 (40.0 – 66.8)25.9 (15.7 – 39.6)20.4 (11.4 – 33.6)
Physical activity29.6 (18.7 – 43.5)48.2 (34.9 – 61.7)22.2 (12.8 – 35.7)
Attitudes of fifth year students toward preventive medicine counseling [% (95% CI)]
Physician as a model for the patients77.8 (64.3 – 87.2)9.3 (3.8 – 20.9)13.0 (6.2 – 25.3)
Importance of prevention counseling88.9 (76.8 – 95.1)1.9 (0.2 – 12.7)9.3 (3.8 – 20.9)
Preference of prevention over treatment9.3 (3.8 – 20.9)79.6 (66.4 – 88.6)11.1 (4.9 – 23.1)
Tab.3  Opinions and attitudes of fifth year students toward prevention
Adjusted OR (95% CI)
Inadequate nutritionRisky alcohol consumptionSmokingNon-compliance with physical activity recommendations
Sex
?Female1111
?Male2.6 (0.6 – 11.5)5.0 (1.9 – 13.0)3.9 (1.2 – 12.2)1.0 (0.4 – 2.5)
Age (year)1.7 (1.1 – 2.5)1.5 (0.9 – 2.3)2.2 (1.2 – 3.8)0.9 (0.6 – 1.4)
Socioeconomic status
?High1111
?Low/medium0.4 (0.1 – 1.5)0.5 (0.2 – 1.3)2.7 (0.8 – 8.7)1.7 (0.7 – 4.1)
Body mass index (kg/m2)
?Normal1111
?Low weight1.2 (0.1 – 13.5)1.8 (0.3 – 12.0)1.0 (0.1 – 8.9)1.4 (0.2 – 7.9)
?Overweight/obesity0.5 (0.3 – 5.9)1.4 (0.3 – 8.0)11.9 (1.5 – 96.1)0.2 (0.0 – 0.8)
University environment (opinion)
?Favorable1111
?Indifferent/unfavorable1.7 (0.3 – 9.1)0.7 (0.2 – 2.0)0.2 (0.5 – 0.8)0.9 (0.3 – 2.6)
Curriculum (opinion)
?Favorable1111
?Indifferent/unfavorable1.3 (0.4 – 4.6)0.9 (0.4 – 1.8)1.8 (0.7 – 4.6)1.2 (0.6 – 2.4)
Medical knowledge
?Adequate*1111
?InadequateNC1.1 (0.3 – 3.9)0.1 (0.2 – 0.5)1.9 (0.5 – 6.4)
Physician as a model (opinion)
?Favorable1111
?Indifferent/unfavorable0.9 (0.4 – 2.4)2.2 (1.2 – 4.2)2.6 (1.2 – 5.6)0.9 (0.5 1.6)
Year of training
?First year1111
?Fifth yearNC0.3 (0.1 – 0.8)0.1 (0.0 – 0.4)2.4 (0.9 – 6.5)
Tab.4  Factors associated with risk prevalence in first and fifth year medical students
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