Accuracy and congruence of patient and physician weight-related discussions: from project CHAT (Communicating Health: Analyzing Talk).

Journal Article

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.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.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).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.

Full Text

Duke Authors

Cited Authors

  • Bodner, ME; Dolor, RJ; Ostbye, T; Lyna, P; Alexander, SC; Tulsky, JA; Pollak, KI

Published Date

  • January 2014

Published In

Volume / Issue

  • 27 / 1

Start / End Page

  • 70 - 77

PubMed ID

  • 24390888

Electronic International Standard Serial Number (EISSN)

  • 1558-7118

International Standard Serial Number (ISSN)

  • 1557-2625

Digital Object Identifier (DOI)

  • 10.3122/jabfm.2014.01.130110

Language

  • eng