Jun Ma1, Lan Xiao, Veronica Yank. 1. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA. maj@pamfri.org
Abstract
OBJECTIVE: To examine rate differences and explanatory factors for lifestyle counseling to obese Latinos versus non-Hispanic whites (NHWs) in U.S. outpatient settings. DESIGN AND METHODS: The 2009 National Ambulatory Medical Care Survey data assessed the provision of weight-related lifestyle counseling during general medical exam visits (n = 688) by obese Latino and NHW adults. The Blinder-Oaxaca decomposition technique to identify the fraction of the overall ethnic difference in counseling rate explained by a selection of measured variables based on the Anderson-Newman-Aday behavioral model were used. RESULTS: Although weight-related lifestyle counseling rates were low in both ethnic groups, the rate among obese Latinos (51.3%) was significantly higher than among NHWs (35.8%) (P = 0.03), with 60% of the difference explained by observed factors. Enabling factors such as provider specialty, metropolitan statistical area, practice type, and provider employment type contributed the most to higher counseling rates among Latinos, whereas geographic region, continuity of care, and health insurance were enabling factors that, along with the predisposing factor of sex, contributed the most in the opposite direction. CONCLUSIONS: Obese Latinos are more likely to receive weight-related counseling during general medical exams than do NHWs, which is partly explained by physician practice and patient factors.
OBJECTIVE: To examine rate differences and explanatory factors for lifestyle counseling to obese Latinos versus non-Hispanic whites (NHWs) in U.S. outpatient settings. DESIGN AND METHODS: The 2009 National Ambulatory Medical Care Survey data assessed the provision of weight-related lifestyle counseling during general medical exam visits (n = 688) by obese Latino and NHW adults. The Blinder-Oaxaca decomposition technique to identify the fraction of the overall ethnic difference in counseling rate explained by a selection of measured variables based on the Anderson-Newman-Aday behavioral model were used. RESULTS: Although weight-related lifestyle counseling rates were low in both ethnic groups, the rate among obese Latinos (51.3%) was significantly higher than among NHWs (35.8%) (P = 0.03), with 60% of the difference explained by observed factors. Enabling factors such as provider specialty, metropolitan statistical area, practice type, and provider employment type contributed the most to higher counseling rates among Latinos, whereas geographic region, continuity of care, and health insurance were enabling factors that, along with the predisposing factor of sex, contributed the most in the opposite direction. CONCLUSIONS:Obese Latinos are more likely to receive weight-related counseling during general medical exams than do NHWs, which is partly explained by physician practice and patient factors.