Elaine Seaton Banerjee1, Sharon J Herring2,3, Katelyn E Hurley4, Katherine Puskarz5, Kyle Yebernetsky6, Marianna LaNoue7. 1. 1 Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA, USA. 2. 2 Department of Medicine, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA. 3. 3 Departments of Public Health, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA. 4. 4 ACT.md, Boston, MA, USA. 5. 5 College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA. 6. 6 Geisinger Health System, Department of Emergency Medicine, Danville, PA, USA. 7. 7 Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Abstract
PURPOSE: Low-income, African American women are disproportionately impacted by obesity. Little is known about the interactions between low-income, African American women who successfully lost weight and their primary care physicians (PCPs). DESIGN: Mixed methods, positive deviance study. SETTING: Urban university-based family medicine practice. PARTICIPANTS: The positive deviance group comprised low-income, African American women who were obese, lost 10% body weight, and maintained this loss for 6 months. MEASURES: The PCP- and patient-reported weight-related variables collected through the electronic medical record (EMR), surveys, and interviews. ANALYSIS: Logistic regression of quantitative variables. Qualitative analysis using modified grounded theory. RESULTS: The EMR documentation by PCPs of dietary counseling and a weight-related medical problem were significant predictors of positive deviant group membership. Qualitative analyses of interviews revealed 5 major themes: framing obesity in the context of other health problems provided motivation; having a full discussion around weight management was important; an ongoing relationship with the physician was valuable; celebrating small successes was beneficial; and advice was helpful but self-motivation was necessary. CONCLUSION: The PCP counseling may be an important factor in promoting weight loss in low-income, African American women. Patients may benefit from their PCPs drawing connections between obesity and weight-related medical conditions and enhancing intrinsic motivation for weight loss.
PURPOSE: Low-income, African American women are disproportionately impacted by obesity. Little is known about the interactions between low-income, African American women who successfully lost weight and their primary care physicians (PCPs). DESIGN: Mixed methods, positive deviance study. SETTING: Urban university-based family medicine practice. PARTICIPANTS: The positive deviance group comprised low-income, African American women who were obese, lost 10% body weight, and maintained this loss for 6 months. MEASURES: The PCP- and patient-reported weight-related variables collected through the electronic medical record (EMR), surveys, and interviews. ANALYSIS: Logistic regression of quantitative variables. Qualitative analysis using modified grounded theory. RESULTS: The EMR documentation by PCPs of dietary counseling and a weight-related medical problem were significant predictors of positive deviant group membership. Qualitative analyses of interviews revealed 5 major themes: framing obesity in the context of other health problems provided motivation; having a full discussion around weight management was important; an ongoing relationship with the physician was valuable; celebrating small successes was beneficial; and advice was helpful but self-motivation was necessary. CONCLUSION: The PCP counseling may be an important factor in promoting weight loss in low-income, African American women. Patients may benefit from their PCPs drawing connections between obesity and weight-related medical conditions and enhancing intrinsic motivation for weight loss.
Authors: Karen M Ashe; Alan C Geller; Jyothi A Pendharkar; Lori Pbert; Sybil Crawford; Melissa A Clark; Christine F Frisard; Cassie A Eno; Jamie Faro; Judith K Ockene Journal: Am J Prev Med Date: 2021-02-22 Impact factor: 5.043