title: Impact of Physician Training on Diagnosis and Counseling of Overweight and Obese Asian Patients.
abstract: Obesity is widely underdiagnosed among Asians, due in part to a lack of physician awareness of the modified diagnostic criteria for Asians. This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients.
  
  
  
  Physicians (N = 16) from five primary care practices received 1 h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12 months before the training (n = 198) and 3 months following the training (n = 163). Physician race (Asian/non-Asian) and clinic setting (private/academic) were included as outcome moderators.
  
  
  
  Patients were predominantly male (63.1 %), with a mean age of 46.0 years (SD = 14.9) and an average BMI of 28.2 (SD = 3.8). Across all physicians, 26.8 and 45.1 % of patients were accurately diagnosed as overweight or obese before and after the training, respectively (p < 0.05). The odds of a physician correctly diagnosing Asian patients as overweight or obese were 102 % higher at post-training after accounting for nesting of patients within physicians. Similarly, weight counseling was higher (65.0 %) following training compared to pre-training levels (43.9 %) but failed to reach significance (p = 0.06).
  
  
  
  Accurate identification and counseling of overweight/obese Asian patients can be improved by education and training. Universal adoption of race-specific guidelines will ensure more successful weight management and reduced morbidity in a rapidly growing Asian population.
authors.affiliation: Department of Family and Community Medicine, University of Texas Medical School at Houston, JJL 324, Houston, TX, 77030, USA. Deepa.A.Vasudevan@uth.tmc.edu.
authors.forename: Deepa A
authors.initials: DA
authors.lastname: Vasudevan
authors.affiliation: Department of Family and Community Medicine, University of Texas Medical School at Houston, JJL 324, Houston, TX, 77030, USA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Northrup
authors.affiliation: Baylor College of Medicine, University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Mandayam
authors.affiliation: School of Public Health, University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Oluwatosin O
authors.initials: OO
authors.lastname: Bamidele
authors.affiliation: Department of Family and Community Medicine, University of Texas Medical School at Houston, JJL 324, Houston, TX, 77030, USA.|Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Stotts
mesh_terms: D044466:Asian People / Q000208:ethnology; D003376:Counseling / Q000379:methods*; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy; D050177:Overweight / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D010820:Physicians; D011320:Primary Health Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013781:Texas / Q000208:ethnology
keywords: Asian; Counseling; Diagnosis; Obese; Overweight