title: Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents.
abstract: OBJECTIVE
  Physicians' use of Motivational Interviewing (MI) techniques when discussing weight with adolescent patients is unknown.
  
  
  METHODS
  We coded audio-recorded encounters between 49 primary care physicians and 180 overweight adolescent patients. During weight discussions, we used the MITI 3.0 to assess: Empathy, MI Spirit, open-ended questions, reflections, MI consistent behaviors (e.g., praising) and MI inconsistent behaviors (e.g., confronting). We examined associations of patient and physician characteristics with (1) MI techniques, (2) time discussing weight, and (3) encounter time.
  
  
  RESULTS
  Physicians used more MI consistent techniques with female patients (p=0.06) and with heavier patients (p=0.02). Physicians with prior MI training also used more MI consistent techniques (p=0.04) and asked more open-ended questions (p=0.05). Pediatricians had a higher MI Spirit score than family physicians (p=0.03). Older patient age was associated with physicians spending less time discussing weight-related topics (p=0.04) and higher BMI percentile was associated with physicians spending more time discussing weight-related topics (p=0.01). Increased use of MI inconsistent techniques was associated with longer encounters (p=0.02).
  
  
  CONCLUSIONS
  Physicians' weight discussions vary based on adolescent and physician characteristics. Importantly, not using MI lengthened encounter time.
  
  
  CONCLUSIONS
  Physicians might consider using MI techniques more and attempt to use these equally with all adolescents.
authors.affiliation: Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA; Department of Community and Family Medicine, Duke University School of Medicine, Durham, USA. Electronic address: kathryn.pollak@duke.edu.
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
authors.affiliation: Durham VA Medical Center (Durham, NC), Center for Health Services Research, Durham, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Coffman
authors.affiliation: Durham VA Medical Center (Durham, NC), Center for Health Services Research, Durham, USA; Department of Medicine, Duke University School of Medicine, Durham, USA.
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.affiliation: Department of Community and Family Medicine, Duke University School of Medicine, Durham, USA; Duke-NUS Graduate Medical School, Singapore.
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.affiliation: Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA.
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyna
authors.affiliation: Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA; Department of Medicine, Duke University School of Medicine, Durham, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
authors.affiliation: Cancer Control and Population Sciences, Duke Cancer Institute, Durham, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Bilheimer
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, USA.
authors.forename: Rowena J
authors.initials: RJ
authors.lastname: Dolor
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, USA.
authors.forename: Pao-Hwa
authors.initials: PH
authors.lastname: Lin
authors.affiliation: School of Human Kinetics, Trinity Western University, Langley, Canada.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Bodner
authors.affiliation: Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, USA.
authors.forename: Terrill
authors.initials: T
authors.lastname: Bravender
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D003142:Communication; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D062405:Motivational Interviewing; D009765:Obesity / Q000517:prevention & control; D010821:Physicians, Family / Q000523:psychology*; D058007:Physicians, Primary Care / Q000523:psychology*; D011320:Primary Health Care; D012959:Socioeconomic Factors; D013637:Tape Recording; D015431:Weight Loss
keywords: Adolescents; Counseling; Interviewing; Motivational; Obesity; Physicians; Weight