Katie O Washington Cole1, Debra L Roter2. 1. Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Room 750, Baltimore, MD 21205, USA. Electronic address: katiewashington@jhu.edu. 2. Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Room 750, Baltimore, MD 21205, USA.
Abstract
OBJECTIVE: To examine the relationship between patient initiation and weight-related behavioral counseling during pregnancy. METHODS: We examined audio recordings of prenatal visits between 22 obstetricians and 120 patients for behavioral counseling using the Roter Interaction Analysis System and the 5A's behavioral counseling framework. We used multivariate regression models to examine the relationship between patient initiation and communication outcomes. RESULTS: Overall, 55% of prenatal visits included any behavioral counseling. Patients initiated counseling episodes 45.5% of these visits. Patients were less verbally dominated by their clinicians in prenatal visits with patient-initiated behavioral counseling episodes (difference in clinician verbal dominance ratio=0.73, 95% CI=0.16-1.30). Patient-initiated counseling episodes included more socioemotional communication relative to those initiated by clinicians (p=0.02). The total duration of counseling was 28s longer (95% CI 0.27-56.0s) and clinicians were more likely to use two or more 5A's strategies (OR=3.61, 95% CI=1.01-12.88) when patients initiated discussions. CONCLUSIONS: Patient initiation may lead to behavioral counseling that is longer in duration and includes more 5A's strategies, possibly mediated by socioemotional communication. PRACTICE IMPLICATIONS: Participatory prenatal care communication may lead to more effective counseling that is responsive to women's concerns.
OBJECTIVE: To examine the relationship between patient initiation and weight-related behavioral counseling during pregnancy. METHODS: We examined audio recordings of prenatal visits between 22 obstetricians and 120 patients for behavioral counseling using the Roter Interaction Analysis System and the 5A's behavioral counseling framework. We used multivariate regression models to examine the relationship between patient initiation and communication outcomes. RESULTS: Overall, 55% of prenatal visits included any behavioral counseling. Patients initiated counseling episodes 45.5% of these visits. Patients were less verbally dominated by their clinicians in prenatal visits with patient-initiated behavioral counseling episodes (difference in clinician verbal dominance ratio=0.73, 95% CI=0.16-1.30). Patient-initiated counseling episodes included more socioemotional communication relative to those initiated by clinicians (p=0.02). The total duration of counseling was 28s longer (95% CI 0.27-56.0s) and clinicians were more likely to use two or more 5A's strategies (OR=3.61, 95% CI=1.01-12.88) when patients initiated discussions. CONCLUSIONS:Patient initiation may lead to behavioral counseling that is longer in duration and includes more 5A's strategies, possibly mediated by socioemotional communication. PRACTICE IMPLICATIONS: Participatory prenatal care communication may lead to more effective counseling that is responsive to women's concerns.
Authors: Debra L Roter; Lori H Erby; Rajiv N Rimal; Katherine C Smith; Susan Larson; Ian M Bennett; Katie Washington Cole; Yue Guan; Matthew Molloy; Jessica Bienstock Journal: J Health Commun Date: 2015
Authors: Mary E Cox; William S Yancy; Cynthia J Coffman; Truls Ostbye; James A Tulsky; Stewart C Alexander; Rebecca J Namenek Brouwer; Rowena J Dolor; Kathryn I Pollak Journal: Patient Educ Couns Date: 2011-02-12
Authors: Katie O Washington Cole; Kimberly A Gudzune; Sara N Bleich; Lawrence J Cheskin; Wendy L Bennett; Lisa A Cooper; Debra L Roter Journal: Patient Educ Couns Date: 2016-12-27
Authors: Bernadette A M Chevalier; Bernadette M Watson; Michael A Barras; William Neil Cottrell Journal: Health Expect Date: 2017-03-30 Impact factor: 3.377