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An analysis of directly observed weight communication processes between primary care practitioners and overweight patients

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McHale_2019_PEC_Weightcommunication_AAM.pdf (471.5Kb)
Date
12/2019
Author
McHale, Calum T.
Cecil, Joanne E.
Laidlaw, Anita H.
Keywords
Overweight
Obesity
Direct observation
Primary healthcare
Weight management
Primary care communication
Weight-related communication
Communication coding
RA0421 Public health. Hygiene. Preventive Medicine
NDAS
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Abstract
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.
Citation
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
Publication
Patient Education and Counseling
Status
Peer reviewed
DOI
https://doi.org/10.1016/j.pec.2019.07.010
ISSN
0738-3991
Type
Journal article
Rights
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
Description
This research was funded by a University of St Andrews 600th Anniversary Doctoral Scholarship.
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/20313

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