A Randomized, Controlled Pilot Study of a Patient-Initiated Approach to Increasing Weight Communication in Primary Care

Not Applicable

Completed

Brief Summary: This study tests the feasibility, acceptability, and preliminary efficacy of using a brief pamphlet in the primary care waiting room focused on promoting patient-initiated weight-related discussions in primary care appointments.

Detailed Description: Obesity is a chronic and complex disease that many national and professional organizations recommend be discussed frequently in primary care. However, rates of weight-related communication in primary care are suboptimal. When patients and physicians communicate about weight (defined as usage of any the 5As-ask, assess, advise, agree, and/or assist-in a weight-related conversation), patients are more likely to improve dietary habits, demonstrate more motivation for health behavior change, attempt weight loss treatment, and lose more weight as compared to patients who do not engage in weight-related communication with their physicians. Interventions have attempted to increase the rates of weight-related communication in primary care. However, they have focused solely on physicians and have only yielded modest efficacy. Intervention with patients on proposed patient-related barriers may be key to improving the rate of weight-related communication in primary care. The waiting room prior to appointments is an underutilized intervention setting. Prior waiting room interventions have shown promising results for increasing health communication between patients and physicians. However, no prior study has focused on weight-related communication. Thus, this study aims to test the feasibility, acceptability, and preliminary efficacy of an experiential pamphlet delivered in the waiting room targeting patient-related barriers to weight communication.

Recruitment & Eligibility

Inclusion Criteria

Present for an appointment at the Family Medicine Office
Indicate that they can speak and read English
Indicate that their Shape is > or = 5 on measure (Stunkard, Sørensen, & Schulsinger, 1983)
Indicate that they are 18 years or older

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Intervention	Brief waiting room pamphlet	Receive experiential pamphlet

Primary Outcome Measures

Name	Time	Method
Feasibility of Recruitment From Primary Care Waiting Room and Intervention Delivery	When study staff is recruiting in the office during the data collection period, approx. 20 days over 6 months	Study flow will be tracked by study staff and compared to pre-determined benchmarks. 1) Percentage of patients who indicate verbal consent for screening (benchmark \>70%), 2) percentage of eligible participants after screening (benchmark \>50%), 3) percentage of participants who refuse to participate because of focus on weight (benchmark \<20%), 4)percentage of participants who complete the experiential pamphlet (benchmark \>80%).
Treatment Acceptability Questionnaire	Immediately after appointment (Same day as intervention delivery)	Intervention participants reported acceptability, as measured by the Treatment Acceptability Questionnaire (Hunsley, 1992). This is a 6-item scale that asks the participant to rate several metrics of acceptability with Likert scale responses (individual items range 1-7, one item is reverse scored). A higher score indicates greater acceptability, a score of 21 is the benchmark for acceptability. Overall range of 6-42.

Secondary Outcome Measures

Name	Time	Method
If Weight Was Spoken About in the Appointment	Immediately after appointment (Same day as intervention delivery)	Participants respond to Yes/No questions about content of their appointment

Locations (1): Drexel University Family Medicine Office
🇺🇸
Philadelphia, Pennsylvania, United States

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