title: Waist circumference measurement: knowledge, attitudes and barriers in patients and practitioners in a multi-ethnic population.
abstract: BACKGROUND
  Currently, body mass index (BMI) is widely used to identify health risk due to overweight or obesity. However, waist circumference is considered by many to be a better indicator of health risk than BMI. The primary health care team are ideally suited to screen for people at high risk of glucose intolerance and increased cardiovascular risk using waist circumference measurement (WCM).
  
  
  OBJECTIVE
  To determine the knowledge and attitudes of patients and primary care practitioners concerning WCM, with particular reference to exploring barriers in a multi-ethnic setting.
  
  
  METHODS
  A qualitative study using purposive sampling, semi-structured interviews and thematic analysis was conducted. Nine general practices were selected from Leicestershire, UK. The participants were 10 practitioners (four practice nurses, six general practitioners) and 18 patients (six south Asians).
  
  
  RESULTS
  Two overarching themes were identified from patient and practitioner interviews: understanding of waist size measurement to assess or monitor risk and attitudes related to perceived barriers and facilitators to waist measurement. A few practitioners felt uncomfortable about carrying out WCM and some perceived that patients might feel embarrassed. Practical barriers raised by professionals included lack of time, extra workload and financial implications. In contrast, patients generally raised few barriers to WCM. Being given an explanation appeared to be what was most important to them. No clear differences emerged when comparing views of patients from different ethnic groups or general practitioners and practice nurses.
  
  
  CONCLUSIONS
  This study adds to our understanding of views on WCM in a multi-ethnic setting, highlighting factors for consideration if WCM is to be facilitated in routine practice.
authors: Department of Health Sciences, University of Leicester and University Hospitals of Leicester NHS Trust, UK. ajd38@le.ac.uk
authors: Alison J
authors: AJ
authors: Dunkley
authors: Margaret A
authors: MA
authors: Stone
authors: Naina
authors: N
authors: Patel
authors: Melanie J
authors: MJ
authors: Davies
authors: Kamlesh
authors: K
authors: Khunti
mesh_terms: D000328:Adult; D000368:Aged; D001210:Asia, Southeastern / Q000208:ethnology; D015992:Body Mass Index; D005194:Family Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D036301:Qualitative Research; D018570:Risk Assessment; D006113:United Kingdom / Q000453:epidemiology; D055105:Waist Circumference / Q000502:physiology