Department of Psychology, University of Florida, Gainesville, Florida, USA.
Department of Counseling Psychology, University of Denver, Denver, Colorado, USA.
Clin Obes. 2021 Oct;11(5):e12468. doi: 10.1111/cob.12468. Epub 2021 Jun 8.
Non-Hispanic Black women have the highest rates of overweight/obesity of any group in the United States. To date, few interventions have worked to reduce overweight/obesity in this population. This study investigated the views of Black women with overweight and obesity treated in a primary care setting regarding desired and undesired verbal and non-verbal behaviours by providers in provider-patient clinical encounters focused on losing weight, maintaining weight loss, and/or obesity. Two focus groups and an individual interview (n = 15) were conducted. Qualitative data analysis yielded five distinct themes, with 11 codes (listed in parenthesis): (a) desired weight-focused discussions (codes: Discussing weight loss with patients and discussing weight-loss maintenance with patients), (b) desired weight-focused support (codes: Supporting patients experiencing weight loss and supporting patients experiencing weight gain), (c) undesired weight-focused discussions (codes: Things to avoid during weight loss discussions and things to avoid during weight gain discussions), (d) desired attitudes and behaviours during weight-focused discussions (codes: Show caring and understanding and encourage behaviour change for weight loss), and (e) building physician-patient rapport (codes: Enable patients to feel respected by doctors, enable patients to feel comfortable with doctors and enable patients to trust their doctors). The qualitative approach employed in this study generates a deep understanding not only of the experiences of Black women patients but also of potential strategies that physicians could employ to succeed in their discussions with patients regarding healthy weight achievement and maintenance.
非西班牙裔黑种女性的超重/肥胖率在美国所有群体中最高。迄今为止,很少有干预措施能有效减少这一人群的超重/肥胖问题。本研究调查了在初级保健环境中接受治疗的超重和肥胖的黑种女性对关注减轻体重、保持体重减轻和/或肥胖的医患临床接触中提供者的期望和不期望的言语和非言语行为的看法。进行了两次焦点小组和一次个人访谈(n=15)。定性数据分析产生了五个不同的主题,有 11 个代码(括号中列出):(a)期望的以体重为重点的讨论(代码:与患者讨论减肥和与患者讨论减肥维持),(b)期望的以体重为重点的支持(代码:支持减肥的患者和支持体重增加的患者),(c)不期望的以体重为重点的讨论(代码:减肥讨论中应避免的事情和体重增加讨论中应避免的事情),(d)以体重为重点讨论时期望的态度和行为(代码:表现出关心和理解,鼓励减肥行为改变),(e)建立医患关系(代码:使患者感到医生的尊重,使患者感到舒适与医生相处并使患者信任他们的医生)。本研究采用的定性方法不仅深入了解了黑种女性患者的体验,还深入了解了医生在与患者讨论健康体重目标和维持方面可能采用的潜在策略。