The obesity epidemic poses serious health risks for Americans by contributing to rising rates of diabetes, hypertension, and also, although less well known, cancer morbidity and mortality rates. Physicians play an integral role in addressing obesity through weight loss, nutrition, and physical activity counseling; however, only 40 percent of overweight or obese patients report receiving such counseling. Our multidisciplinary team of investigators with expertise in social psychology, patient-physician communication, and epidemiology, and a track record in examining disparities, obesity, and communication proposes to explore how patients and physicians discuss weight loss. """"""""The specific aims of this study are to determine (1) whether the way physicians and patients discuss weight loss leads to actual weight loss among overweight and obese patients; (2) whether patient-physician discussions about weight loss affect patients' readiness, self-efficacy, outcome expectancies, and motivation to lose weight, and (3) whether physicians communicate differently when they discuss weight loss than when they discuss other topics. To accomplish these aims, we propose to audio record 480 patient-physician primary care encounters (40 family medicine and internal medicine physicians practicing in the Durham community; 12 patients each, 6 with overweight and 6 with obese patients). Coders will assess the frequency with which primary care physicians use patient-centered techniques or motivational interviewing techniques as a measure of the quality of the weight loss counseling. As a measure of the quantity of weight loss discussions, coders will rate what patients and physicians discuss (e.g., caloric restriction, physical activity, referral to nutritionists, prescription weight loss medication, etc.). In addition to the objective measures from the audio recorded visits, we will assess patients' weight loss three months after the visit as well as their immediate perceptions of the content of the visit, their physicians' communication, their relationship with their physician, and psychosocial mediators of weight loss (e.g., readiness, self-efficacy, outcome expectancies, and motivation to lose weight). Results of this study will expand the field of patient-physician communication by examining how physicians and patients discuss weight loss; this information can be used to develop interventions targeted toward patients and physicians to improve weight-related communication and thus help curb the obesity epidemic. ? ?

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
1R01CA114392-01A1
Application #
7048093
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Patrick, Heather A
Project Start
2006-06-01
Project End
2009-05-31
Budget Start
2006-06-01
Budget End
2007-05-31
Support Year
1
Fiscal Year
2006
Total Cost
$372,916
Indirect Cost
Name
Duke University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Bodner, Michael E; Dolor, Rowena J; Ostbye, Truls et al. (2014) Accuracy and congruence of patient and physician weight-related discussions: from project CHAT (Communicating Health: Analyzing Talk). J Am Board Fam Med 27:70-7
Pollak, Kathryn I; Coffman, Cynthia J; Alexander, Stewart C et al. (2012) Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity? Fam Pract 29:553-60
Gulbrandsen, Pal; Ostbye, Truls; Lyna, Pauline et al. (2012) The influence of physician communication style on overweight patients' perceptions of length of encounter and physician being rushed. Fam Med 44:183-8
Pollak, Kathryn I; Alexander, Stewart C; Tulsky, James A et al. (2011) Physician empathy and listening: associations with patient satisfaction and autonomy. J Am Board Fam Med 24:665-72
Pollak, Kathryn I; Coffman, Cynthia J; Alexander, Stewart C et al. (2011) Predictors of weight loss communication in primary care encounters. Patient Educ Couns 85:e175-82
Alexander, Stewart C; Cox, Mary E; Boling Turer, Christy L et al. (2011) Do the five A's work when physicians counsel about weight loss? Fam Med 43:179-84
Cox, Mary E; Yancy Jr, William S; Coffman, Cynthia J et al. (2011) Effects of counseling techniques on patients' weight-related attitudes and behaviors in a primary care clinic. Patient Educ Couns 85:363-8
Pollak, Kathryn I (2011) Incorporating MI techniques into physician counseling. Patient Educ Couns 84:1-2
Pollak, Kathryn I; Alexander, Stewart C; Coffman, Cynthia J et al. (2010) Physician communication techniques and weight loss in adults: Project CHAT. Am J Prev Med 39:321-8
Dolor, Rowena J; Østbye, Truls; Lyna, Pauline et al. (2010) What are physicians' and patients' beliefs about diet, weight, exercise, and smoking cessation counseling? Prev Med 51:440-2

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