Personal Health Behaviors and Counseling by Nurse Practitioners

Quick Takes

  • Healthy lifestyle behaviors can have a significant reduction in morbidity and mortality in CVD and are an expectation of professional practice.
  • Healthy lifestyle behaviors include exercise and consumption of fruits, vegetables, and dietary protein.
  • The odds for counseling increased 20-75% when nurse practitioners engaged in the behaviors themselves.

Study Questions:

What is the frequency of lifestyle counseling, including nutrition, and the relationship between personal lifestyle behaviors and patient counseling practices?


This was a cross-sectional study, using an online survey consisting of 16 items that focused on four general categories of nurse practitioners to determine the rate of counseling patients on healthy lifestyle and their own lifestyle behaviors. Items were based on previous questionnaires regarding counseling practices among physicians, medical students, and nurse practitioners. Data were analyzed and correlation analysis was used to identify significant relationships between personal lifestyle behaviors and patient counseling practices. Ordinal logistic regression analysis was then used to identify predictors and odds for health behavior counseling.


Surveys of 1,200 nurse practitioners were included in the analysis. Participants were 98% female, and 86% white. Mean age was 46.6 ± 11.3 years (range 25-79 years) and their mean body mass index (BMI) was 26.5 ± 5.4 kg/m2 (range 16.2-54.8 kg/m2). The majority reported counseling “usually” or “often” for healthy weight (54%), moderate–vigorous physical activity (53%), and fruits/vegetables (57%), whereas only 44% and 17% reported “usually” or “often” counseling for dietary protein and muscle strengthening. When nurse practitioners did not personally engage in the behavior, the odds for counseling were significantly reduced: nurse practitioners were 21% less likely to counsel for moderate–vigorous physical activity (odds ratio [OR] 0.79 [0.65–0.97], p = 0.026), 27% less likely to counsel for muscle strengthening (OR 0.73 [0.60–0.90], p = 0.004), 57% less likely to counsel for fruit/vegetable consumption (OR 0.43 [0.35–0.54], p < 0.001), and 72% less likely to counsel for dietary protein (OR 0.28 [0.18–0.45], p < 0.001). Personal BMI did not predict counseling for a healthy weight.


This study supported the findings from previous studies that healthy lifestyle counseling was more likely to occur if the health care provider engaged in healthy lifestyle themselves.


As cardiovascular health care providers, healthy lifestyle counseling is the cornerstone of patient care to reduce cardiovascular events. This study supports that providers who engage in healthy behaviors will encourage patients to do the same. Promoting healthy behaviors should be incorporated into our workflows to promote a healthy workforce, and model behaviors for our patients.

Clinical Topics: Cardiovascular Care Team, Prevention

Keywords: Counseling, Healthy Lifestyle, Nurse Practitioners

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