RESUMEN
PURPOSE: The purpose of this study was to examine the relationship between stage of change for smoking cessation and stage of change for (1) fruit and vegetable consumption and (2) physical activity. DESIGN: The data come from a cross-sectional telephone survey administered to a stratified random sample of health plan members (n = 9675). SETTING: This study was conducted at a mixed-model health plan with approximately 1 million adult members. SUBJECTS: Respondents were adults age 18 and older, who were randomly selected from five health plan product groups: commercial fully insured, commercial self-insured, two publicly subsidized plans, and Medicare supplemental insurance. Response rates ranged from 74.7% to 90.1% across these groups. MEASURES: The assessment included demographics and stage of change for smoking cessation, physical activity, and fruit and vegetable intake. Bivariate relationships among variables were analyzed with the use of contingency tables. Ordered logistic regression was used to examine the effects of stage of change for fruit and vegetable consumption and physical activity on stage of change for smoking while controlling for other factors. RESULTS: Stage of change for smoking is more clearly related to stage of change for fruit and vegetable consumption (chi2 = 161.3, p < .001; Cramer's V = .11, p < .001) than to stage of change for physical activity (chi2 = 89. 7, p < .001; Cramer's V = .08, p < .001). However, stage of change for fruit and vegetable consumption and physical activity are not strong predictors of stage of change for smoking. CONCLUSIONS: This study indicates that stage of change for both fruit and vegetable consumption and physical activity are independent constructs from stage of change for smoking cessation.
Asunto(s)
Dieta , Ejercicio Físico/psicología , Frutas , Conductas Relacionadas con la Salud , Cese del Hábito de Fumar/psicología , Verduras , Adolescente , Adulto , Anciano , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Minnesota , Modelos TeóricosRESUMEN
PURPOSE: The purpose of this study was to estimate the total medical expenditures attributable to physical inactivity patterns among members of a large health plan, Blue Cross Blue Shield of Minnesota. METHODS: The study used a cost-of-illness approach to attribute medical and pharmacy costs for specific diseases to physical inactivity in 2000. Relative risks come from the scientific literature, demonstrating that heart disease, stroke, hypertension, type 2 diabetes, colon cancer, breast cancer, osteoporosis, depression, and anxiety are directly related to individual physical activity patterns in adults. Data sources were the 2000 Behavioral Risk Factor Surveillance System and medical claims incurred in 2000 among 1.5 million health plan members aged > or =18 years. Primary analysis was completed in 2002. RESULTS: Nearly 12% of depression and anxiety and 31% of colon cancer, heart disease, osteoporosis, and stroke cases were attributable to physical inactivity. Heart disease was the most expensive outcome of physical inactivity within the health plan population, costing US dollar 35.3 million in 2000. Total health plan expenditures attributable to physical inactivity were US dollar 83.6 million, or US dollar 56 per member. CONCLUSIONS: This study confirms the growing body of research quantifying physical inactivity as a serious and expensive public health problem. The costs associated with physical inactivity are borne by taxpayers, employers, and individuals in the form of higher taxes to subsidize public insurance programs and increased health insurance premiums.