Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA.
Obesity (Silver Spring). 2013 Aug;21(8):1734-41. doi: 10.1002/oby.20285. Epub 2013 May 21.
To examine rate differences and explanatory factors for lifestyle counseling to obese Latinos versus non-Hispanic whites (NHWs) in U.S. outpatient settings.
The 2009 National Ambulatory Medical Care Survey data assessed the provision of weight-related lifestyle counseling during general medical exam visits (n = 688) by obese Latino and NHW adults. The Blinder-Oaxaca decomposition technique to identify the fraction of the overall ethnic difference in counseling rate explained by a selection of measured variables based on the Anderson-Newman-Aday behavioral model were used.
Although weight-related lifestyle counseling rates were low in both ethnic groups, the rate among obese Latinos (51.3%) was significantly higher than among NHWs (35.8%) (P = 0.03), with 60% of the difference explained by observed factors. Enabling factors such as provider specialty, metropolitan statistical area, practice type, and provider employment type contributed the most to higher counseling rates among Latinos, whereas geographic region, continuity of care, and health insurance were enabling factors that, along with the predisposing factor of sex, contributed the most in the opposite direction.
Obese Latinos are more likely to receive weight-related counseling during general medical exams than do NHWs, which is partly explained by physician practice and patient factors.
在美国门诊环境中,考察对肥胖拉丁裔和非西班牙裔白人(NHW)进行生活方式咨询的比率差异和解释因素。
2009 年全国门诊医疗调查数据评估了肥胖拉丁裔和 NHW 成年人在一般医疗检查就诊期间提供与体重相关的生活方式咨询的情况(n=688)。使用布伦纳-奥克萨卡分解技术,根据安德森-纽曼-阿代行为模型选择的一组测量变量,确定咨询率整体种族差异中可由选择变量解释的部分。
尽管两个种族群体的与体重相关的生活方式咨询率都较低,但肥胖拉丁裔的咨询率(51.3%)明显高于 NHW(35.8%)(P=0.03),其中 60%的差异可由观察到的因素解释。促进因素,如医生专业、大都市统计区、实践类型和提供者就业类型,对拉丁裔更高的咨询率贡献最大,而地理区域、连续性护理和医疗保险是促进因素,与倾向因素性别一起,在相反的方向上贡献最大。
与 NHW 相比,肥胖拉丁裔在一般医疗检查期间更有可能接受与体重相关的咨询,这部分可以通过医生的实践和患者因素来解释。