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

Calum T. McHale; Joanne E. Cecil; Anita H. Laidlaw

doi:10.1016/j.pec.2019.07.010

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

Calum T. McHale, Joanne E. Cecil, Anita H. Laidlaw

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	2214-2222
Journal	Patient Education and Counseling
Volume	102
Issue number	12
Early online date	23 Jul 2019
DOIs	https://doi.org/10.1016/j.pec.2019.07.010
Publication status	Published - Dec 2019

Keywords

Overweight
Obesity
Direct observation
Primary healthcare
Weight management
Primary care communication
Weight-related communication
Communication coding

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.pec.2019.07.010

McHale_2019_PEC_Weightcommunication_AAM
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
Accepted author manuscript, 472 KBLicence: CC BY-NC-ND

Joanne Elizabeth Cecil
- jc100st-andrews.acuk
- School of Medicine - Lecturer
- Population and Behavioural Science Division
Person: Academic

Cite this

@article{ea4cbca3a89348859951598b8239f1b3,

title = "An analysis of directly observed weight communication processes between primary care practitioners and overweight patients",

abstract = "ObjectiveTo analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations.MethodsConsultations 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.ResultsWeight 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.ConclusionWeight 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 implicationPCP 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.",

keywords = "Overweight, Obesity, Direct observation, Primary healthcare, Weight management, Primary care communication, Weight-related communication, Communication coding",

author = "McHale, {Calum T.} and Cecil, {Joanne E.} and Laidlaw, {Anita H.}",

note = "This research was funded by a University of St Andrews 600th Anniversary Doctoral Scholarship.",

year = "2019",

month = dec,

doi = "10.1016/j.pec.2019.07.010",

language = "English",

volume = "102",

pages = "2214--2222",

journal = "Patient Education and Counseling",

issn = "0738-3991",

publisher = "Elsevier Ireland Ltd",

number = "12",

}

TY - JOUR

T1 - An analysis of directly observed weight communication processes between primary care practitioners and overweight patients

AU - McHale, Calum T.

AU - Cecil, Joanne E.

AU - Laidlaw, Anita H.

N1 - This research was funded by a University of St Andrews 600th Anniversary Doctoral Scholarship.

PY - 2019/12

Y1 - 2019/12

N2 - ObjectiveTo analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations.MethodsConsultations 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.ResultsWeight 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.ConclusionWeight 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 implicationPCP 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.

AB - ObjectiveTo analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations.MethodsConsultations 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.ResultsWeight 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.ConclusionWeight 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 implicationPCP 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.

KW - Overweight

KW - Obesity

KW - Direct observation

KW - Primary healthcare

KW - Weight management

KW - Primary care communication

KW - Weight-related communication

KW - Communication coding

U2 - 10.1016/j.pec.2019.07.010

DO - 10.1016/j.pec.2019.07.010

M3 - Article

SN - 0738-3991

VL - 102

SP - 2214

EP - 2222

JO - Patient Education and Counseling

JF - Patient Education and Counseling

IS - 12

ER -

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

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Profiles

Joanne Elizabeth Cecil

Cite this