title: Provider and patient intervention to improve weight loss: a pilot study in a public hospital clinic.
abstract: OBJECTIVE
  To assess the efficacy of a literacy-appropriate weight loss intervention targeting providers and patients in improving physicians' weight loss counseling and patients' self-reported beliefs, and self-efficacy.
  
  
  METHODS
  The study took place in a public hospital nephrology clinic. The intervention included two physician workshops and a small group patient education. Physician-patient communication was observed and coded. Structured interviews assessed patient recall of weight loss recommendations, weight-related beliefs, and self-efficacy.
  
  
  RESULTS
  64 patient visits were observed before and after the intervention. 75% of patients were African American, 96% lacked private insurance, 71% had low literacy skills; mean body mass index (BMI) of 35 kg/m(2). Physician counseling improved significantly post-intervention, particularly in assessing, supporting and advising patients about weight loss and exercise. Patients reported increases in recall of weight loss recommendations and were more likely to report greater confidence about losing weight (52% vs. 70%, p<0.01).
  
  
  CONCLUSIONS
  This pilot study offers promising directions to address provider and patient barriers to weight loss education and counseling in a public hospital.
  
  
  CONCLUSIONS
  Hospital-based weight loss interventions need to target both physicians and patients.
authors.affiliation: Louisiana State University Health Sciences Center-Shreveport, Department of Medicine and Pediatrics, Shreveport, LA 71130, United States. tdavis1@lsuhsc.edu
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.forename: Pat F
authors.initials: PF
authors.lastname: Bass
authors.forename: Connie L
authors.initials: CL
authors.lastname: Arnold
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.forename: Estela M
authors.initials: EM
authors.lastname: Kennen
authors.forename: Mary V
authors.initials: MV
authors.lastname: Bocchini
authors.forename: Joan
authors.initials: J
authors.lastname: Blondin
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003142:Communication; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006779:Hospitals, Public; D006801:Humans; D008145:Louisiana; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education* / Q000523:psychology; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control / Q000523:psychology; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic / Q000458:organization & administration*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D010865:Pilot Projects; D015397:Program Evaluation; D020377:Self Efficacy; D015431:Weight Loss