In it for the long haul: the complexities of managing overweight in family practice: qualitative thematic analysis from the Health eLiteracy for Prevention in General Practice (HeLP-GP) trial

BMC Primary Care

Research

Jane Lloyd¹  Mark Harris¹  Sharon Parker¹  Richard Osborne²  Carmel McNamara³  Shoko Saito⁴  Don Nutbeam⁵  Elizabeth Denney-Wilson⁶  Sue Randall⁷  Katrina Paine⁸ 

[1] Centre for Primary Health Care and Equity, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia;Centre of Global Health and Equity, Swinburne University of Technology, Melbourne, Australia;College of Nursing and Health Science, Flinders University, Adelaide, Australia;Health Equity and Research Development Unit, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia;Public Health in the School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia;Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Camperdown, Australia;Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia;Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia;Centre for Primary Health Care and Equity, Faculty of Medicine and Health, University of New South Wales, Kensington, Australia;

关键词: Family practice;    Managing overweight;    Obesity;    Patient-provider relationships;    Primary care;    mySnapp;    Get healthy telephone coaching;   

DOI  :  10.1186/s12875-023-01995-w

 received in 2022-09-29, accepted in 2023-01-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAustralia has one of the highest rates of overweight and obesity in the developed world, and this increasing prevalence and associated chronic disease morbidity reinforces the importance of understanding the attitudes, views, and experiences of patients and health providers towards weight management interventions and programs. The purpose of this study was to investigate patients, family practitioners and family practice nurses’ perceptions and views regarding the receipt or delivery of weight management within the context of the HeLP-GP intervention.MethodsA nested qualitative study design including semi-structured interviews with family practitioners (n = 8), family practice nurses (n = 4), and patients (n = 25) attending family practices in New South Wales (n = 2) and South Australia (n = 2). The patient interviews sought specific feedback about each aspect of the intervention and the provider interviews sought to elicit their understanding and opinions of the strategies underpinning the intervention as well as general perceptions about providing weight management to their patients. Interviews were recorded and transcribed verbatim, and coding and management conducted using NVivo 12 Pro. We analysed the interview data using thematic analysis.ResultsOur study identified three key themes: long-term trusting and supportive relationships (being ‘in it for the long haul’); initiating conversations and understanding motivations; and ensuring access to multi-modal weight management options that acknowledge differing levels of health literacy. The three themes infer that weight management in family practice with patients who are overweight or obese is challenged by the complexity of the task and the perceived motivation of patients. It needs to be facilitated by positive open communication and programs tailored to patient needs, preferences, and health literacy to be successful.ConclusionsProviding positive weight management in family practice requires ongoing commitment and an open and trusting therapeutic relationship between providers and patients. Behaviour change can be achieved through timely and considered interactions that target individual preferences, are tailored to health literacy, and are consistent and positive in their messaging. Ongoing support of family practices is required through funding and policy changes and additional avenues for referral and adjunctive interventions are required to provide comprehensive weight management within this setting.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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