Dissertation
A randomized, controlled pilot study of a patient-initiated approach to increasing weight communication in primary care
Doctor of Philosophy (Ph.D.), Drexel University
Jun 2020
DOI:
https://doi.org/10.17918/00001024
Abstract
Obesity is a complex disease that many organizations recommend be discussed frequently in primary care. However, the frequency of weight-related communication in primary care is low. Interventions to increase the frequency of weight-related communication have focused solely on physicians and have only yielded modest efficacy. Intervention promoting patient-initiated discussions may be key to improving the frequency of weight-related communication in primary care. This study aims to test the feasibility, acceptability, and preliminary efficacy of an experiential pamphlet delivered in the waiting room targeting patient barriers to weight communication in primary care. Sixty adult participants with overweight or obesity were recruited from a primary care office. Participants were randomized to either receive a pamphlet with information on weight and prompts to ask their doctors about weight and health, or to a non-intervention control group. Participants completed assessments after their appointment. Participants were specifically queried if weight was discussed and answered follow-up questions about the weight discussion. Study flow was tracked and compared to pre-set benchmarks to assess feasibility. Mixed methods were utilized to measure acceptability quantitatively with participants and physicians and qualitatively with physicians and staff. Mann Whitney U tests, logistic regressions, and ANOVAs were utilized to analyze main outcomes. This study met three of four feasibility benchmarks. Quantitative and qualitative results demonstrated participant, physician, and staff acceptability of the intervention pamphlet. Frequency of weight discussion at appointment was not significantly different between the intervention and control condition. Self-reported health predicted likelihood of weight discussions such that participants with poorer self-reported health were more likely to report communication about weight at the visit. In conclusion, the intervention pamphlet was feasible to deliver in a primary care waiting room and was acceptable to participants, physicians and staff. However, the pamphlet did not change the frequency of weight discussions in primary care. Interventions that promote patient and provider collaboration may be more effective. The feasibility and acceptability of a brief intervention delivered in the waiting room is promising for future interventions.
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Details
- Title
- A randomized, controlled pilot study of a patient-initiated approach to increasing weight communication in primary care
- Creators
- Jocelyn E. Remmert
- Contributors
- Meghan L. Butryn (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- viii, 109 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 991014695241204721