Predictors of weight loss communication in primary care encounters

PATIENT EDUCATION AND COUNSELING

卷:85

Article

Pollak, Kathryn I.^1,2  Coffman, Cynthia J.^3,4,5  Alexander, Stewart C.^3,4,6  Manusov, Justin R. E.¹  Ostbye, Truls^2,7  Tulsky, James A.^3,4,6  Lyna, Pauline¹  Esoimeme, Iguehi¹  Brouwer, Rebecca J. Namenek²  Dolor, Rowena J.^3,4,6 

[1] Duke Univ, Med Ctr, Canc Prevent Detect & Control Res Program, Durham, NC 27706 USA

[2] Duke Univ, Med Ctr, Dept Community & Family Med, Durham, NC 27706 USA

[3] Durham VA Med Ctr, Durham, NC USA

[4] Ctr Hlth Serv Res, Durham, NC USA

[5] Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC 27706 USA

[6] Duke Univ, Med Ctr, Dept Med, Durham, NC 27706 USA

[7] Duke NUS Grad Med Sch, Singapore, Singapore

关键词: Obesity;    Physicians;    Time;    Weight;    Counseling;    Motivational;    Interviewing;   

DOI  :  10.1016/j.pec.2011.03.001

来源: Elsevier

【 摘 要 】

Objective: Evidence suggests that physicians' use of motivational interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' used MI techniques. Methods: Forty primary care physicians and 461 of their overweight or obese patients were audio recorded and surveyed. Results: Weight-related topics were commonly discussed (nutrition 78%, physical activity 82%, and BMI/weight 72%). Use of MI techniques was low. A multivariable linear mixed model was fit to time spent discussing weight, adjusting for patient clustering within physician. More time was spent with obese patients (p = .0002), by African American physicians (p = .03), family physicians (p = .02), and physicians who believed patients were embarrassed to discuss weight (p = .05). Female physicians were more likely to use MI techniques (p = .02); African American physicians were more likely to use MI-inconsistent techniques (p < .001). Conclusion: Primary care physicians routinely counsel about weight and are likely to spend more time with obese than with overweight patients. Internists spend less time on weight. Patient and systems factors do not seem to influence physicians' use MI techniques. Practice implications: All physicians, particularly, male and African American physicians, could increase their use of MI techniques to promote more weight loss among patients. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free