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|Title:||Accuracy and congruence of patient and physician weight-related discussions: From project CHAT (Communicating health: Analyzing talk)|
|Citation:||Bodner, M.E., Dolor, R.J., Østbye, T., Lyna, P., Alexander, S.C., Tulsky, J.A., Pollak, K.I. (2014-01). Accuracy and congruence of patient and physician weight-related discussions: From project CHAT (Communicating health: Analyzing talk). Journal of the American Board of Family Medicine 27 (1) : 70-77. ScholarBank@NUS Repository. https://doi.org/10.3122/jabfm.2014.01.130110|
|Abstract:||Objective: Primary care providers should counsel overweight patients to lose weight. Rates of self-reported, weight-related counseling vary, perhaps because of self-report bias. We assessed the accuracy and congruence of weight-related discussions among patients and physicians during audio-recorded encounters. Methods: We audio-recorded encounters between physicians (n = 40) and their overweight/obese patients (n = 461) at 5 community-based practices. We coded weight-related content and surveyed patients and physicians immediately after the visit. Generalized linear mixed models assessed factors associated with accuracy. Results: Overall, accuracy was moderate: patient (67%), physician (70%), and congruence (62%). When encounters containing weight-related content were analyzed, patients (98%) and physicians (97%) were highly accurate and congruent (95%), but when weight was not discussed, patients and physicians were more inaccurate and incongruent (patients, 36%; physicians, 44%; 28% congruence). Physicians who were less comfortable discussing weight were more likely to misreport that weight was discussed (odds ratio, 4.5; 95% confidence interval, 1.88 -10.75). White physicians with African American patients were more likely to report accurately no discussion about weight than white physicians with white patients (odds ratio, 0.30; 95% confidence interval, 0.13- 0.69). Conclusion: Physician and patient self-report of weight-related discussions were highly accurate and congruent when audio-recordings indicated weight was discussed but not when recordings indicated no weight discussions. Physicians' overestimation of weight discussions when weight is not discussed constitutes missed opportunities for health interventions.|
|Source Title:||Journal of the American Board of Family Medicine|
|Appears in Collections:||Staff Publications|
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