An analysis of directly observed weight communication processes between primary care practitioners and overweight patients
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Objective To analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations. Methods Consultations between 14 PCPs and 218 overweight patients (BMI ≥25 kg/m2) were video recorded. Weight communication was coded using the Roter Interaction Analysis System (RIAS) and the novel St Andrews Issue Response Analysis System (SAIRAS). Communication code frequencies were analysed. Results Weight discussion occurred in 25% of consultations with overweight patients; 26% of these had weight-related consultation outcomes (e.g. weight-related counselling and referrals, stated weight-related intention from patients). Weight discussions were more likely to occur if PCPs provided space to patient attempts to discuss weight (p = 0.013). Longer weight discussions (p < 0.001) and contextualising weight as problematic when PCP/patient-initiated weight discussion (p < 0.001) were associated with weight-related consultation outcomes. Conclusion Weight was rarely discussed with overweight patients, however PCP space provision to patient weight-discussion initiation attempts increased weight discussion. When weight was discussed, increased time and/or contextualising weight as a problem increased the likelihood of weight-related consultation outcomes. Practical implication PCP use of specific communication approaches when discussing, contextualising and responding to patient weight may facilitate weight-related discussion and consultation outcomes and could lead to more effective patient weight management.
McHale , C T , Cecil , J E & Laidlaw , A H 2019 , ' An analysis of directly observed weight communication processes between primary care practitioners and overweight patients ' , Patient Education and Counseling , vol. 102 , no. 12 , pp. 2214-2222 . https://doi.org/10.1016/j.pec.2019.07.010
Patient Education and Counseling
Copyright © 2019 Published by Elsevier B.V. This work is made available online in accordance with the publisher’s policies. This is the author created, accepted version manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1016/j.pec.2019.07.010
DescriptionThis research was funded by a University of St Andrews 600th Anniversary Doctoral Scholarship.
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