Evans-Hoeker E A, Ramalingam N S, Harden S M
Department of Obstetrics and Gynecology Carilion Clinic Roanoke Virginia USA.
Department of Obstetrics and Gynecology Virginia Tech Carilion School of Medicine Roanoke Virginia USA.
Obes Sci Pract. 2019 Apr 30;5(4):304-311. doi: 10.1002/osp4.338. eCollection 2019 Aug.
Research suggests that patient and provider conversations about healthy eating and physical activity behaviours may lead to patients' increased health behaviours, access to dietary and physical activity resources, and weight management. The American College of Obstetrics and Gynecology (ACOG) has a number of weight management intervention options, but it is unclear if providers have conversations about intervention options with their patients who are of reproductive age. The purpose of this work was to evaluate the degree to which gynaecology healthcare providers offer the weight management intervention options as recommended by ACOG.
Cross-sectional study of gynaecology providers in Southwest Virginia utilizing an electronic survey to identify weight management perceptions and current clinical practices. Responses were measured using quantitative methods, and agreeability and frequency responses were measured using a 5-point Likert scale.
Twenty-three of the 31 eligible providers (74.2%) completed the survey. Providers acknowledge that patients need weight management discussions and they feel comfortable and are willing to have these discussions. While physical activity recommendations were consistent among providers, they did not reflect the complete physical activity recommendations for Americans. Consistency in dietary recommendations was lacking. Although providers make recommendations for physical activity and/or diet at least sometimes, they rarely utilize other methods of weight management as outlined in the ACOG recommendations, such as referrals to other providers, programmes or medications.
Areas for improvement in weight management practices include frequency of counselling, consistency in dietary counselling and frequency of utilization of weight loss medications and referrals to ancillary services. These results can be used to aid the development of methods for targeting these deficiencies.
研究表明，患者与医疗服务提供者就健康饮食和体育活动行为进行的沟通，可能会促使患者增加健康行为、获取饮食和体育活动资源并进行体重管理。美国妇产科医师学会（ACOG）有多种体重管理干预选项，但尚不清楚医疗服务提供者是否会与育龄期患者讨论这些干预选项。这项工作的目的是评估妇科医疗服务提供者按照ACOG建议提供体重管理干预选项的程度。
对弗吉尼亚西南部的妇科医疗服务提供者进行横断面研究，采用电子调查问卷来确定体重管理观念和当前临床实践。使用定量方法测量回答情况，使用5点李克特量表测量认同度和频率回答情况。
31名符合条件的医疗服务提供者中有23名（74.2%）完成了调查。医疗服务提供者承认患者需要进行体重管理讨论，他们对此感到自在并愿意进行这些讨论。虽然医疗服务提供者在体育活动建议方面较为一致，但这些建议并未反映出针对美国人的完整体育活动建议。饮食建议缺乏一致性。尽管医疗服务提供者至少有时会给出体育活动和/或饮食方面的建议，但他们很少采用ACOG建议中概述的其他体重管理方法，如转介给其他医疗服务提供者、项目或药物。
体重管理实践中需要改进的方面包括咨询频率、饮食咨询的一致性以及减肥药物的使用频率和转介至辅助服务的情况。这些结果可用于帮助制定针对这些不足的方法。
