Kathryn I Pollak1, Cynthia J Coffman2, Stewart C Alexander3, Truls Østbye4, Pauline Lyna5, James A Tulsky6, Alicia Bilheimer5, Rowena J Dolor7, Pao-Hwa Lin7, Michael E Bodner8, Terrill Bravender9. 1. Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA; Department of Community and Family Medicine, Duke University School of Medicine, Durham, USA. Electronic address: kathryn.pollak@duke.edu. 2. Durham VA Medical Center (Durham, NC), Center for Health Services Research, Durham, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA. 3. Durham VA Medical Center (Durham, NC), Center for Health Services Research, Durham, USA; Department of Medicine, Duke University School of Medicine, Durham, USA. 4. Department of Community and Family Medicine, Duke University School of Medicine, Durham, USA; Duke-NUS Graduate Medical School, Singapore. 5. Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA. 6. Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA; Department of Medicine, Duke University School of Medicine, Durham, USA. 7. Department of Medicine, Duke University School of Medicine, Durham, USA. 8. School of Human Kinetics, Trinity Western University, Langley, Canada. 9. Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, USA.
Abstract
OBJECTIVE: Physicians' use of Motivational Interviewing (MI) techniques when discussing weight with adolescent patients is unknown. METHODS: We coded audio-recorded encounters between 49 primary care physicians and 180 overweight adolescent patients. During weight discussions, we used the MITI 3.0 to assess: Empathy, MI Spirit, open-ended questions, reflections, MI consistent behaviors (e.g., praising) and MI inconsistent behaviors (e.g., confronting). We examined associations of patient and physician characteristics with (1) MI techniques, (2) time discussing weight, and (3) encounter time. RESULTS: Physicians used more MI consistent techniques with female patients (p=0.06) and with heavier patients (p=0.02). Physicians with prior MI training also used more MI consistent techniques (p=0.04) and asked more open-ended questions (p=0.05). Pediatricians had a higher MI Spirit score than family physicians (p=0.03). Older patient age was associated with physicians spending less time discussing weight-related topics (p=0.04) and higher BMI percentile was associated with physicians spending more time discussing weight-related topics (p=0.01). Increased use of MI inconsistent techniques was associated with longer encounters (p=0.02). CONCLUSION: Physicians' weight discussions vary based on adolescent and physician characteristics. Importantly, not using MI lengthened encounter time. PRACTICE IMPLICATIONS: Physicians might consider using MI techniques more and attempt to use these equally with all adolescents.
OBJECTIVE: Physicians' use of Motivational Interviewing (MI) techniques when discussing weight with adolescent patients is unknown. METHODS: We coded audio-recorded encounters between 49 primary care physicians and 180 overweight adolescent patients. During weight discussions, we used the MITI 3.0 to assess: Empathy, MI Spirit, open-ended questions, reflections, MI consistent behaviors (e.g., praising) and MI inconsistent behaviors (e.g., confronting). We examined associations of patient and physician characteristics with (1) MI techniques, (2) time discussing weight, and (3) encounter time. RESULTS: Physicians used more MI consistent techniques with female patients (p=0.06) and with heavier patients (p=0.02). Physicians with prior MI training also used more MI consistent techniques (p=0.04) and asked more open-ended questions (p=0.05). Pediatricians had a higher MI Spirit score than family physicians (p=0.03). Older patient age was associated with physicians spending less time discussing weight-related topics (p=0.04) and higher BMI percentile was associated with physicians spending more time discussing weight-related topics (p=0.01). Increased use of MI inconsistent techniques was associated with longer encounters (p=0.02). CONCLUSION: Physicians' weight discussions vary based on adolescent and physician characteristics. Importantly, not using MI lengthened encounter time. PRACTICE IMPLICATIONS: Physicians might consider using MI techniques more and attempt to use these equally with all adolescents.
Authors: Ronald M Epstein; Peter Franks; Kevin Fiscella; Cleveland G Shields; Sean C Meldrum; Richard L Kravitz; Paul R Duberstein Journal: Soc Sci Med Date: 2005-04-15 Impact factor: 4.634
Authors: Albina Dumic; Ivan Miskulin; Matea Matic Licanin; Aida Mujkic; Daniela Cacic Kenjeric; Maja Miskulin Journal: Int J Environ Res Public Health Date: 2017-12-04 Impact factor: 3.390
Authors: Katrina Oselinsky; Colleen G Duncan; Heather E Martinez; Dan J Graham Journal: Int J Environ Res Public Health Date: 2021-02-27 Impact factor: 3.390