Provider and patient intervention to improve weight loss: a pilot study in a public hospital clinic.
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.
Davis
Terry C
TC
Louisiana State University Health Sciences Center-Shreveport, Department of Medicine and Pediatrics, Shreveport, LA 71130, United States. tdavis1@lsuhsc.edu
Wolf
Michael S
MS
Bass
Pat F
PF
Arnold
Connie L
CL
Huang
Jian
J
Kennen
Estela M
EM
Bocchini
Mary V
MV
Blondin
Joan
J
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