Deepa A Vasudevan1, Thomas F Northrup2, Sreedhar Mandayam3, Oluwatosin O Bamidele4, Angela L Stotts2,5. 1. Department of Family and Community Medicine, University of Texas Medical School at Houston, JJL 324, Houston, TX, 77030, USA. Deepa.A.Vasudevan@uth.tmc.edu. 2. Department of Family and Community Medicine, University of Texas Medical School at Houston, JJL 324, Houston, TX, 77030, USA. 3. Baylor College of Medicine, University of Texas Medical School at Houston, Houston, TX, USA. 4. School of Public Health, University of Texas Medical School at Houston, Houston, TX, USA. 5. Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston, Houston, TX, USA.
Abstract
BACKGROUND AND OBJECTIVES: Obesity is widely underdiagnosed among Asians, due in part to a lack of physician awareness of the modified diagnostic criteria for Asians. This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients. METHODS: Physicians (N = 16) from five primary care practices received 1 h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12 months before the training (n = 198) and 3 months following the training (n = 163). Physician race (Asian/non-Asian) and clinic setting (private/academic) were included as outcome moderators. RESULTS: Patients were predominantly male (63.1 %), with a mean age of 46.0 years (SD = 14.9) and an average BMI of 28.2 (SD = 3.8). Across all physicians, 26.8 and 45.1 % of patients were accurately diagnosed as overweight or obese before and after the training, respectively (p < 0.05). The odds of a physician correctly diagnosing Asian patients as overweight or obese were 102 % higher at post-training after accounting for nesting of patients within physicians. Similarly, weight counseling was higher (65.0 %) following training compared to pre-training levels (43.9 %) but failed to reach significance (p = 0.06). CONCLUSIONS: Accurate identification and counseling of overweight/obese Asian patients can be improved by education and training. Universal adoption of race-specific guidelines will ensure more successful weight management and reduced morbidity in a rapidly growing Asian population.
BACKGROUND AND OBJECTIVES:Obesity is widely underdiagnosed among Asians, due in part to a lack of physician awareness of the modified diagnostic criteria for Asians. This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients. METHODS: Physicians (N = 16) from five primary care practices received 1 h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12 months before the training (n = 198) and 3 months following the training (n = 163). Physician race (Asian/non-Asian) and clinic setting (private/academic) were included as outcome moderators. RESULTS:Patients were predominantly male (63.1 %), with a mean age of 46.0 years (SD = 14.9) and an average BMI of 28.2 (SD = 3.8). Across all physicians, 26.8 and 45.1 % of patients were accurately diagnosed as overweight or obese before and after the training, respectively (p < 0.05). The odds of a physician correctly diagnosing Asian patients as overweight or obese were 102 % higher at post-training after accounting for nesting of patients within physicians. Similarly, weight counseling was higher (65.0 %) following training compared to pre-training levels (43.9 %) but failed to reach significance (p = 0.06). CONCLUSIONS: Accurate identification and counseling of overweight/obese Asian patients can be improved by education and training. Universal adoption of race-specific guidelines will ensure more successful weight management and reduced morbidity in a rapidly growing Asian population.
Authors: Jennifer L Kraschnewski; Christopher N Sciamanna; Heather L Stuckey; Cynthia H Chuang; Erik B Lehman; Kevin O Hwang; Lisa L Sherwood; Harriet B Nembhard Journal: Med Care Date: 2013-02 Impact factor: 2.983