Tennessee dietitians' counseling practices regarding the role of exercise in the management of non-insulin-dependent diabetes mellitus

This study surveyed a random sample of 286 dietetic practitioners from the Tennessee Dietetic Association's mailing list and obtained an 86% response rate. Forty percent (n = 98) of the 246 respondents reported that they counseled clients with noninsulin- dependent diabetes mellitus (NIDDM) and were classified as "counselors." "Noncounselors" comprised the remainder of the sample. Ninety-four percent of the counselors indicated that they provided exercise information to some or all of their clients with NIDDM, with a mean monthly caseload of 11 clients. The percentage of time spent discussing exercise in initial counseling sessions (TSSl) was 14, and the percentage in follow-up counseling sessions (TSS2) was 19. Counselors usually or always discussed an average of 10 of 16 exercise-related topics during initial counseling sessions. Over 80% of the respondents identified 3 very important reasons to include information about exercise: exercise is important in managing diabetes; exercise decreases risk factors for other complications of diabetes; and client requires weight loss. Only 1% of the respondents identified a "belief that information about exercise is NOT important" and 9% a "belief that it is NOT appropriate for a dietitian to discuss exercise" as very important reasons to exclude exercise information. Knowledgeable respondents answered correctly 16 or more of 22 questions about exercise and its role in diabetes management. Sixty-two percent of counselors and 61% of noncounselors were considered knowledgeable. There was a statistically significant difference (alpha = .05) in the means of the TSSl scores of the 2 groups of counselors; counselors categorized as not knowledgeable spent a greater percentage of time in the initial counseling session discussing exercise-related topics. Ten personal health promotion activities were assessed. Seventy-six percent of all respondents participated in 7 or more of these practices in an "ideal" manner, with a mean of 8 activities. The majority of Tennessee dietetic practitioners did set a good example for their clients in health promotion practices, though there was room for improvement, particularly by decreasing body weight and increasing exercise.