Association of depression symptoms with receipt of healthcare provider advice on physical activity among US adults

• Published in: Journal of affective disorders Vol. 262; pp. 304 - 309
• Main Authors: Grabovac, I., Stefanac, S., Smith, L., Haider, S., Cao, C., Jackson, S.E., Dorner, T.E., Waldhoer, T., Rieder, A., Yang, L.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-02-2020
• Subjects: Adult; Advice; Counseling - statistics & numerical data; Cross-Sectional Studies; Depression - psychology; Depression - therapy; Depressive symptoms; Exercise - psychology; Female; Health care providers; Health Personnel - psychology; Humans; Male; Middle Aged; NHANES; Nutrition Surveys; Physical activity; Practice Patterns, Physicians' - statistics & numerical data; Prevalence; Professional Role - psychology; Self Report; United States - epidemiology; Young Adult; United States; Depressive symptoms; NHANES; Health care providers; Advice; Physical activity
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2019.11.023

•29.5% participants with moderate-severe symptoms reported receiving PA advice.•Likelihood of receiving advice increased with weight status.•Odds of getting advice increase with depression symptom severity.•Education, health care access, ethinicity increase the odds of advice provision.
Given the high burden and prevalence of depression, various guidelines underscore the role of healthcare providers in supplying advice on physical activity (PA) as a potential modifying factor influencing the incidence and severity of depressive symptoms in adults. We aimed to investigate the extent to which healthcare providers provide PA advice to adults with depressive symptoms in the US.
Data on adults aged 20–64 years (n = 4971) in the National Health and Nutrition Examination Study between 2011 and 2016 were analysed. Depressive symptoms were assessed using the Patient Health Questionnaire and response options were categorised as “none or minimal”, “mild”, “moderate-severe”. Receipt of PA advice from a healthcare provider was self-reported. We restricted our study sample to adults free from chronic diseases.
Higher odds of receiving advice to exercise were reported among adults with mild (OR = 1.7, 95% CI: 1.3–2.3) and moderate-severe depressive symptoms (OR = 1.7, 95% CI: 1.0–2.8). Furthermore, exercise advice was more commonly reported among adults who were overweight, obese, Hispanic, Asian, being insured with private insurance, with education higher than high school, and had access to a routine place for health care.
Social and culutral aspects of overweight/obesity may prohibit generalizations. Cross sectional design does not allow for causal realtionships.
In the US, fewer than one in three adults experiencing symptoms of depression report having received exercise advice from a healthcare provider. Providing such advice may be a sustainable clinical strategy in reducing the incidence and severity of depression symptoms.