The gut microbiome (gMicrobiome)-a dynamic ecosystem of microorganisms-is emerging as a correlate of healthy lifestyle. Patients may not be aware of this. General Internal Medicine patients completed surveys evaluating gMicrobiome knowledge, lifestyle knowledge, dietary intake, physical activity, sleep, and stress. Surveys were given pre-/post-education (n = 112) and at 1 month follow-up (n = 60). The educational-module comprised a video and handout describing how lifestyle enhances gMicrobiome and health outcomes. Post-educational-module, 9 of 19 (47%) statements showed favorable change in knowledge (P < 0.05). Two statements reached statistical significance at 1-month follow-up: "Exercise influences the types of bacteria present in the digestive system" [7 (12%) to 24 (41%), P = 0.004] and "An inactive lifestyle promotes the growth of healthy types of digestive system bacteria" [12 (20%) to 24 (41%), P = 0.035]. We observed a small but favorable change in knowledge but not behavior. Large lifestyle changes are challenging to adopt, and education alone is necessary but insufficient for change. Our results confirm that education is a viable first step to establish the importance of pursuing lifestyle changes, perhaps moving from pre-contemplation to contemplation. Baseline knowledge in our participants was higher than anticipated, indicating that this intervention may have been too introductory. Future interventions should investigate baseline knowledge.

Prior work has shown that primary care patients endorse one or more of the following PA goals, weight maintenance, overall benefits, stress reduction, weight loss, tone/body shape, overall well-being, cardiovascular fitness, and increased energy. Using self-determination theory as a guide, the present study tested whether these eight goals had indirect effects on likelihood of meeting aerobic PA guidelines through internal motivation, external motivation or both. Patients (N = 642; 60.7% female; 44.5% Black; Mage = 50.26 years) were recruited from the waiting room of a primary care clinic to complete a questionnaire. Results showed that PA goals of tone/shape, weight maintenance, and stress reduction had dual, opposing influences on likelihood of meeting aerobic PA guidelines via internal and external motivation. The goal of weight loss had a negative indirect effect on likelihood of meeting guidelines via external motivation. The PA goals of overall health benefits and cardiovascular health had singular, positive indirect effects on PA via internal motivation. Well-being had a direct positive effect on PA and a negative indirect effect via external motivation. Finally, the goal of improved energy had a direct positive effect on likelihood to meet PA guidelines. Implications for clinical practice and theory development are discussed.

One approach to increasing physical activity (PA) among adults is to develop interventions targeting PA goals that could be implemented in the primary care setting. However, there is little understanding of the types of goals that individuals bring with them into the primary care setting, which is a necessary first step in building interventions. There were three objectives of the study. One was to identify the types of PA goals held by primary care patients. Another was to examine whether there were racial differences among types of PA goals held by primary care patients. A final objective was to examine the relationship between PA goals and PA behaviors (e.g., meet PA guidelines, number of breaks taken from PA routine). Adults (N = 626; Mage = 51.47, SD = 16.32) were recruited from the waiting room of a primary care clinic over a 30-day span to complete a questionnaire on PA and goals. The most commonly endorsed PA goals included, weight maintenance, overall health benefits, weight loss, well-being, body tone and/or shape, stress reduction, cardiovascular health, and energy level. Black patients were more likely than White patients to report weight loss and weight maintenance goals. Weight maintenance, overall health, and stress reduction are the goals for which the greatest percentage of individuals reported meeting aerobic PA guidelines. Finally, number of breaks taken and average length of breaks were similar across type of PA goal. A relatively small number of goals reflected a majority of the goals pursued by participants in this study. Racial differences in adoption of weight loss and weight maintenance goals highlight the need for further investigation into such differences. Finally, future research should consider the role that goal setting plays in PA adherence, paying particular attention to disparate levels of PA across racial groups.

OBJECTIVE:Alcohol misuse is common among primary care patients, yet many do not receive treatment because doctors believe problem drinkers are "in denial," or are unwilling to change their drinking habits. The real problem, however, may be that patients are being offered treatment modalities that do not meet their needs. This study was designed to measure the acceptability of various treatment options among drinkers who were currently not receiving treatment.METHOD:Patients in a primary care clinic were given a self-report questionnaire that included: (1) the Alcohol Use Disorders Questionnaire, (2) a measure of readiness to change drinking behavior, and (3) a list of treatment modalities to be rated based on level of interest.RESULTS:Within a random sample of 402 patients, 40.2% reported high risk drinking and 16.3% reported problem drinking. Among the latter group, 89.3% were either considering change, or had begun to take steps to make changes in their drinking behaviors. When asked about treatment preferences, the modalities most frequently recommended by physicians-group therapy and Alcoholics Anonymous-were among the least acceptable. The most popular options were getting help from a primary care doctor and taking a medication that would make it easier to avoid drinking without making them sick if they drank.CONCLUSIONS:The belief that problem drinkers are unwilling to change was not supported by this study. Treatment for problem drinking should involve a collaborative evaluation of options with an emphasis on patient preference and treatment within the primary care setting.