Views of Diverse Primary Care Patients on the Roles of Healthcare Providers and Staff and the Influence of Other Variables in Their Weight Management

Tucker CM, Williams JL, Wippold GM, Bilello LA, Morrissette TA, Good AJ, Shah NR, Rowland NE
Source: Clin Obes
Publication Year: 2018
Patient Need Addressed: Chronic Conditions, Patient satisfaction/engagement
Population Focus: Low income
Demographic Group: Adult, Racial and ethnic minority groups
Study Design: Other Study Design
Type of Literature: White
link: https://www.ncbi.nlm.nih.gov/pubmed/29052345
Abstract

The prevalence of overweight/obesity is disproportionately higher among racial/ethnic minority and low-income patients. The purpose of this study was to survey racially diverse, low-income patients regarding their experiences with and desires regarding their providers’ involvement in weight management. Adult patients (N = 529), including mostly African American (42.7%), White (44.6%) and low-income (55.5% with incomes <$30 000) patients from 7 Patient-Centered Medical Homes voluntarily completed a brief anonymous survey while waiting to see their providers. Only 19.8% of the patients said that their primary care provider frequently or very frequently talked with them about their weight. Older patients as compared to younger patients, as well as males compared to females, were more likely to have their primary care provider talk to them about their diet and physical activity during the last year. It was also found that 56.9% of the patients were interested in getting help from their doctor to connect with resources for weight management in their community. African American patients, as compared to White patients, were more interested in getting such help. These results suggest that there is a need to establish healthcare policies and training in primary care settings that are designed to ensure that primary care providers routinely talk with all of their patients, including their female and older patients, about their weight and weight management services. Additionally, primary care administrators need to play an increased role in identifying, developing, and advocating for affordable weight management services, particularly in African American and low-income communities.

Insights Results

Overview of article

  • This study surveyed racially diverse, low-income patients regarding their experiences with and desires regarding their providers’ involvement in weight management

Methods of article

  • The survey used to assess such experiences was The Patient Survey, an 18-item survey. This survey was modified by the authors for this specific study to integrate more demographic information, to remove less relevant components (e.g., physical activity, healthy eating). The survey was designed to obtain patients’ opinions about the role of their healthcare provider in managing their weight and their likelihood of participating in a medical office based health promotion program. Specifically, the survey assessed information about the following variable domains: 1) health and health behavior; 2) primary care and health behavior change; 3) community weight management resources; and 4) demographics. An example of a health question is “When you consider your current body weight, do you consider yourself to be…” Response options were on a 5-point scale ranging from 1 = very
    underweight to 5 = very overweight

Results

  • There was a significant positive relationship between age and discussions about diet and physical activity
  • Most participants said they were “somewhat overweight” or “very overweight”
  • Men were significantly more likely to talk about weight management with their PCPs than women
  • Patients’ race/ethnicity, gender, household income, and age were not significantly associated with whether their doctor/provider was respectful in discussing their weight
  • African American patients were significantly more likely than non-Hispanic White patients to be interested in getting help from their doctor/provider and their doctor’s office to connect with resources for weight management
  • There was a significant negative relationship between income and whether the patients were interested in getting help from their doctor’s office to connect with resources for weight management in the community
  • Cost, time, and transportation were the factors that patients identified as having the greatest impact on their willingness to access resources for weight management
  • Patients most strongly desired that their providers engage in patient-provider discussions about the risks of overweight/obesity. Patients also expressed that they would like their providers to be involved in their weight management including asking patients about their interest in weight loss during office visits and screening patients for weight status during office visits

Key takeaways/implications

  • Limitations to the study include that these identified barriers are perceived by patients, that only 60% reported being overweight (nonresponse bias), non-collection of Body Mass Index or other quantitative indicators of weight, and concerns with generalizability
  • Future areas of research warranted include a similar study composed exclusively of overweight patients, evaluation of impact of number of providers, and evaluation of primary care weight management practices from a nationally representative sample
  • This study is particularly important in that it provides support for patient-centered
    culturally sensitive healthcare, which includes considering patients as valuable experts on what will and will not work for them in terms of weight management and lifestyle modifications

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