Summary Non‐Hispanic Black women have the highest rates of overweight/obesity of any group in the United States. To date, few interventions have worked to reduce overweight/obesity in this population. This study investigated the views of Black women with overweight and obesity treated in a primary care setting regarding desired and undesired verbal and non‐verbal behaviours by providers in provider‐patient clinical encounters focused on losing weight, maintaining weight loss, and/or obesity. Two focus groups and an individual interview (n = 15) were conducted. Qualitative data analysis yielded five distinct themes, with 11 codes (listed in parenthesis): (a) desired weight‐focused discussions (codes: Discussing weight loss with patients and discussing weight‐loss maintenance with patients), (b) desired weight‐focused support (codes: Supporting patients experiencing weight loss and supporting patients experiencing weight gain), (c) undesired weight‐focused discussions (codes: Things to avoid during weight loss discussions and things to avoid during weight gain discussions), (d) desired attitudes and behaviours during weight‐focused discussions (codes: Show caring and understanding and encourage behaviour change for weight loss), and (e) building physician‐patient rapport (codes: Enable patients to feel respected by doctors, enable patients to feel comfortable with doctors and enable patients to trust their doctors). The qualitative approach employed in this study generates a deep understanding not only of the experiences of Black women patients but also of potential strategies that physicians could employ to succeed in their discussions with patients regarding healthy weight achievement and maintenance.

Summary 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.

BackgroundApproximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. However, what is not well understood is the extent to which individual components of the PCMH model, such as the quality of physician-patient interactions and organizational features of care, contribute to patient activation. This study’s objective is to determine the relative importance of the PCMH constructs or domains to patient activation among individuals living with diabetes.MethodsThis study is a cross-sectional analysis of 1253 primary care patients surveyed with type II diabetes. The dependent variable, patient activation, was assessed using the Patient Activation Measure (PAM). Independent variables included 7 PCMH domains- organizational access, integration of care, comprehensive knowledge, office staff helpfulness, communication, interpersonal treatment and trust. Ordered logistic regression was performed to determine whether each PCMH domain was independently associated with patient activation, followed by a final ordered logistic regression that included all the PCMH domains in a single adjusted model.ResultsUsing the full adjusted model, the odds of patients reporting higher activation scores (PAM) were found to be significant in the domains that represented organizational access (OR 1.56, 95% CI 1.31–1.85) and comprehensive knowledge (OR 1.44, 95% CI 1.13–1.85).ConclusionsMany practices have struggled with the challenge to develop fully functional patient-centered medical homes. In an effort to become more patient-centered, this study aimed to address what factors activated diabetic patients to adhere to diabetes management plan. Understanding these factors can help identify PCMH attributes that practices can prioritize and improve upon to assist their patients in improving health outcomes.Trial registrationStudy was not a clinical trial; therefore it was not registered.

By implementing criteria for oxycodone CR prescribing in an innovative, comprehensive, and unified patient-centered practice model, the authors saw a significant decrease in the number of oxycodone CR tablets prescribed per month and also a decrease in total prescriptions per month.