Views of diverse primary care patients on the roles of healthcare providers and staff and the influence of other variables in their weight management

Abstract

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.

Needs Assessment for Weight Management: The Learning Health System Network Experience

“…Both “lack of respect” and “increased judgment” have been previously linked to delaying/avoiding seeking medical advice 11, 16, 42, 43. Results of our study predominantly identified as white race were similar to those described in a study 15 with a large African American patient population. The similar experiences expressed by these sociodemographically different patient populations point to a critical need to raise awareness of patient experiences and develop clinical practice strategies for effectively engaging patients with overweight or obesity in empathetic and respectful ways.…”

“…A final limitation is that although we surveyed patients from 5 diverse institutions, our respondents were predominantly non-Hispanic white (93%). Despite the uniformity of the race and ethnicity of our population, the self-reported experiences and attitudes toward their PCP are similar to those identified by study samples of differing race/ethnicity 15 …”

“…Despite high interest by patients in receiving weight management resources from their PCP, 15 many PCPs do not broach the subject with their patients45, 46, 47 and less than a third of respondents in our survey indicated that their PCP had a role in their weight management. Primary care practitioners may see weight management as outside of their expertise, and patients may be seeking weight management support from other health care providers (eg, specialists and dietitians) or from commercial sources.…”

“…Although patients indicate that one of the biggest contributions a PCP can make in helping them reduce their weight is to simply ask them about their interest in losing weight, 15 many PCPs may be under the impression that asking about weight negatively affects their patient-provider rapport. Although this is a possibility, asking about interest in discussing weight is what patients want.…”

“…Despite the consistency of these guidelines and evidence that adhering to guidelines increases patient motivation for weight loss, these guidelines are not always followed by health care providers 10, 11, 12, 13. Furthermore, few studies have rigorously examined patients’ experiences with and expectations about weight management in primary care 14, 15, 16. One of the few studies that did so was a survey of patients previously conducted by our study team in a primary care setting 14 .…”