Oral Presentation Australian & New Zealand Obesity Society 2014 Annual Scientific Meeting

Getting taboo issues on the table: talking about overweight and obesity in New Zealand General Practice (#40)

Lesley Gray 1 , Tony Dowell 1 , Lindsay Macdonald 1 , Rachel Tester 1 , Maria Stubbe 1
  1. University of Otago, Wellington, Wellington, NZ, New Zealand

Background:The role of primary care thus far appears under supported and underutilised in obesity, in contrast to notable success relating to smoking cessation. General practitioners and primary care nurses report varying success in their interactions with patients regarding weight management and identify a lack of appropriate resources to apply opportunistically in consultations.This paper describes the development and pilot of a novel brief opportunistic intervention (TabOO: Talking about overweight and obesity).

Method: This was a three phase qualitative study: an existing corpus of recorded health interaction consultations were analysed; a opportunistic intervention for weight management was designed ; the intervention was piloted to assess its practicality and acceptability for clinicians and patients in primary care.

Results: Video recordings of 183 medical consultations were reviewed for lifestyle and weight content. A subset of 38 recordings were selected for interactional analysis. A further 20 consultations were recorded to assess acceptability of the intervention involving16 general practice, 23 general practitioners, 7 primary care nurses, and 58 patients. Clinicians and patients were subsequently interviewed.

Discussion: Effective interactional strategies were usually, but not always, related weight to the patient’s presenting clinical problem. This paper will look at some of the interactional analysis examined through videos and transcripts to highlight the interactional delicacies observed across the phases of this study.

Conclusion: Primary care practitioners have a range of strategies available for raising the subject of weight reduction, but expressed a lack confidence in overall management of the topic. When practitioners receive appropriate support (in the form of brief training and information resources) they become more comfortable in offering support to patients, and patients are accepting of this level of intervention.

  1. Jackson SE, Wardle J, Johnson F, Finer N, Beeken RJ. The impact of a health professional recommendation on weight loss attempts in overweight and obese British adults: a cross-sectional analysis. British Medical Journal Open. 2013; 3(11): p. e003693.
  2. Claridge R, Gray L, Stubbe M, Macdonald L, Tester R, Dowell A. General Practitioner Opinion of Weight Management Interventions in New Zealand. Journal of Primary Health Care. 2014 (in press Sept 2014).