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Diagnostic Radiology Resident Compliance with Recommended Health Guidelines

Posted Jul 31, 2008 Updated Apr 7, 2023
By Jannette Collins MD MEd FCCP , James L. Hinshaw MD , Elizabeth Fine MS , Mark A. Albanese PhD
19 min read

Rationale and Objectives

To determine diagnostic radiology resident compliance with recommended health guidelines for physical activity, body weight, diet, related health indicators, and the effects of the resident work environment on compliance.

Materials and Methods

A request was electronically mailed to members of the Association of Program Directors in Radiology and the Association of Program Coordinators in Radiology in May 2007 and again in June 2007, asking members to forward to their radiology residents an invitation to complete an online health survey. Frequency counts and Fisher’s exact test, respectively, were used to summarize results and to determine statistically significant relationships between survey variables.

Results

A total of 811 radiology residents completed the survey, representing 18% of 4,412 diagnostic radiology residents. Five hundred forty-five (67.2%) of 811 were male and 264 (32.6%) female. Two hundred ten (25.9%) were first-year, 239 (29.5%) second-year, 201 (24.8%) third-year, and 161 (19.9%) fourth-year residents. Three hundred two (37.2%) engaged in recommended guidelines for physical activity and ≤465 (57.3%) complied with each of multiple federal dietary guidelines (excluding alcohol intake). Up to 329 (40.6%) residents did not know whether they were in compliance with various dietary guidelines. A total of 426 (52.5%) residents reported working ≥60 hours/week, which significantly correlated with less physical activity ( P = .013).

Conclusion

A substantial number of residents are out of compliance with federal guidelines for physical activity and diet and are not knowledgeable about their personal dietary intake. Long work hours are related to a lack of physical activity. Radiology programs may be able to influence resident health practices by modifying work hours and the working environment, encouraging healthy dietary intake and physical activity, and instituting campaigns to inform residents and faculty about health guidelines and available wellness programs.

Studies show that maintaining a healthy weight, participating in regular physical exercise, following recommended dietary guidelines, recognizing and limiting the effects of stress, and screening for and treating high cholesterol and blood pressure lead to longer and healthier lives. Yet studies show that among American adults, the majority do not follow recommended guidelines for physical activity and diet, worker stress is high, one in four have high blood pressure, and upwards of 20% have high levels of total cholesterol ( ). The increasing prevalence of overweight and obese adults, now higher than 60%, has reached epidemic proportions ( ). Average American adult caloric consumption has increased significantly, especially consumption of non-nutritious and unhealthy foods ( ). Routine exercise is becoming a rarity among Americans, both in children and adults. Studies show that after this lifestyle pattern is established, it is very difficult to reverse ( ). Avoiding excess weight gain during early adult years may be pivotal in preventing future adverse health effects, including cardiovascular disease, and may establish a foundation for maintaining lifelong healthy habits in adulthood and for serving as healthy role models for children.

Radiology faculty serve as role models to residents and medical students, potentially influencing the choices trainees make regarding their health. Resident work hours, program flexibility in work hours, food served at department functions, wellness programs offered by programs or the institutions in which they are housed, and subtle cues that reflect faculty values regarding personal and community health are examples of factors that potentially influence the choices made by trainees. The influence that programs have on trainee health habits has the potential to impact a trainee’s satisfaction with life long beyond residency and affect the culture of the practices trainees eventually join. There are many unanswered questions regarding the adequacy of training programs in promoting good health among its trainees and faculty. The purpose of this study was to determine radiology resident compliance with recommended health guidelines for physical activity, body weight, diet and related health indicators, and the effects of the resident work environment on compliance.

Materials and methods

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Results

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Physical Activity

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Table 1

Contributing Factors for Residents not Engaging in at Least 30 Minutes of Moderate-intensity Physical Activity on Most Days of the Week during the Past 4 Weeks

Yes No Not enough time 455 (89.4) 54 (10.6) Lack self-motivation 220 (43.2) 289 (56.8) Exercising is unenjoyable 52 (10.2) 457 (89.8) Exercising is inconvenient 146 (28.7) 363 (71.3) Exercising is boring 47 (9.2) 462 (90.8) Lack confidence in ability to be physically active 8 (1.6) 501 (98.4) Fear being injured or have been injured recently 21 (4.1) 488 (95.9) Lack self-management skills 48 (9.4) 461 (90.6) Lack encouragement, support, or companionship 42 (8.3) 467 (91.7) No convenient parks, sidewalks, bicycle trails, or walking paths 39 (7.7) 470 (92.3) Not aware of fitness recommendations 3 (.60) 506 (99.4) Physical limitations 10 (2.0) 499 (98.0)

Note: Percentages are indicated in parentheses and are based on 509 respondents who answered the items.

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Diet and Nutrition

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Table 2

Resident Compliance with US Department of Agriculture Dietary Guidelines

Agree Disagree Do Not Know Ate ≥2 cups fruit/day 346 (42.7) 426 (52.5) 39 (4.8) Ate ≥2.5 cups vegetables/day 420 (51.8) 340 (41.9) 51 (6.3) Consumed <10% calories from saturated fatty acids 302 (37.2) 281 (34.6) 228 (28.1) Consumed <300 mg/day cholesterol 344 (42.4) 138 (17.0) 329 (40.6) Kept trans-fatty acid consumption as low as possible 465 (57.3) 134 (16.5) 212 (26.1) Kept daily fat intake between 20–35% of calories 387 (47.7) 140 (17.3) 284 (35.0) Consumed <2,300 mg sodium/day 296 (36.5) 191 (23.6) 324 (40.0) Consumed ≤1 (women) or ≤2 (men) alcoholic drinks/day 730 (90.0) 59 (7.3) 22 (2.7) Consumed ≥3-ounce equivalents of whole grain products/day 445 (54.9) 205 (25.3) 161 (19.9) Consumed 3 cups fat-free or low-fat diary products/day 329 (40.6) 408 (50.3) 74 (9.1)

Note: Percentages are indicated in parentheses and are based on 811 respondents, all of whom answered each item.

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Clinical Data

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Work Hours

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Personal Illness

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Complimentary Health Programs

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Table 3

Programs Residents Would Use if Offered Free of Charge by Their Employer at Their Place of Work

Yes No Blood pressure and/or cholesterol screening 532 (65.6) 279 (34.4) Personal nutritional assessment by a dietitian 344 (42.4) 467 (57.6) Stress management 269 (33.2) 542 (66.8) Immunizations 579 (71.4) 232 (28.6) Ergonomic consultation 384 (47.3) 427 (52.7) Personal counseling 175 (21.6) 636 (78.4)

Note: Percentages are indicated in parentheses and are based on 811 responses, all of whom answered each item.

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Comments

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Table 4

Summary of Resident Comments to Item #18

Aspects of Job That Are an Impediment to Maintaining a Healthy Lifestyle How Work Could Be Changed to Promote a Healthy Lifestyle Not enough time for physical activity or for routine health care (and guilt when studying or spending time with spouse/children when there is free time to do so) Make the work day shorter or more flexible (be able to come to work a little later or leave a little earlier on some days); provide personal days for routine health care Unhealthy food served at grand rounds Instead of pizza, offer turkey subs and fruit 24-hour work shift when on call and lack of sleep, the effects of which last 3–4 days Institute a night float system to have a consistent schedule and allow the body to adapt to change in sleep schedule No access to convenient, affordable gym Provide an onsite gym or reduced cost of membership at an offsite fitness center with extended hours; provide taxi vouchers for transportation home from gym when the public transportation at night after work is infrequent or not safe Radiologist lifestyle is inherently sedentary Encourage and permit residents to leave the work area during the day to take a walk and stretch; put treadmills in the reading room; put a stair climber in front of an ergonomically correct desk; provide exercise balls in place of or in addition to chairs in the department Ergonomically poor working environment leading to eye and joint pain Provide all residents with an ergonomic consult and special equipment when appropriate; provide ergonomic interface devices at every workstation Limited time or food options to allow for a healthy lunch (or no lunch break at all) Provide more than 20 minutes for lunch to avoid purchase of unhealthy vending machine food and provide convenient, quick healthy food alternatives onsite (ideally with nutritional information displayed) Lack of encouragement by faculty to be physically active and eat healthy; lack of awareness by program director/department head on importance of physical and mental health issues Promote intramural activities; avoid displays of unhealthy food (eg, cakes, cookies) in public work areas; offer personal nutritional assessments New baby has reduced ability to get regular physical exercise Provide adequate daycare support Program does not provide lighter lead aprons for interventional procedures, leading to shoulder, knee, and back pain Provide every resident with their own lead apron (and lead glasses) at the beginning of the first year

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Relationships Between Variables

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Discussion

Physical Activity

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Diet and Nutrition

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Clinical Data

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Workplace Intervention

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Summary

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Acknowledgment

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Appendix

Health Survey

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Academic Radiology, Volume 15, Issue 8
Journals General Radiology
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