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Lee DN, Sadasivam RS, Stevens EM. Developing Mood-Based Computer-Tailored Health Communication for Smoking Cessation: Feasibility Randomized Controlled Trial. JMIR Form Res 2023; 7:e48958. [PMID: 38133916 PMCID: PMC10770788 DOI: 10.2196/48958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Computer-tailored health communication (CTHC), a widely used strategy to increase the effectiveness of smoking cessation interventions, is focused on selecting the best messages for an individual. More recently, CTHC interventions have been tested using contextual information such as participants' current stress or location to adapt message selection. However, mood has not yet been used in CTCH interventions and may increase their effectiveness. OBJECTIVE This study aims to examine the association of mood and smoking cessation message effectiveness among adults who currently smoke cigarettes. METHODS In January 2022, we recruited a web-based convenience sample of adults who smoke cigarettes (N=615; mean age 41.13 y). Participants were randomized to 1 of 3 mood conditions (positive, negative, or neutral) and viewed pictures selected from the International Affective Picture System to induce an emotional state within the assigned condition. Participants then viewed smoking cessation messages with topics covering five themes: (1) financial costs or rewards, (2) health, (3) quality of life, (4) challenges of quitting, and (5) motivation or reasons to quit. Following each message, participants completed questions on 3 constructs: message receptivity, perceived relevance, and their motivation to quit. The process was repeated 30 times. We used 1-way ANOVA to estimate the association of the mood condition on these constructs, controlling for demographics, cigarettes per day, and motivation to quit measured during the pretest. We also estimated the association between mood and outcomes for each of the 5 smoking message theme categories. RESULTS There was an overall statistically significant effect of the mood condition on the motivation to quit outcome (P=.02) but not on the message receptivity (P=.16) and perceived relevance (P=.86) outcomes. Participants in the positive mood condition reported significantly greater motivation to quit compared with those in the negative mood condition (P=.005). Participants in the positive mood condition reported higher motivation to quit after viewing smoking cessation messages in the financial (P=.03), health (P=.01), quality of life (P=.04), and challenges of quitting (P=.03) theme categories. We also compared each mood condition and found that participants in the positive mood condition reported significantly greater motivation to quit after seeing messages in the financial (P=.01), health (P=.003), quality of life (P=.01), and challenges of quitting (P=.01) theme categories than those in the negative mood condition. CONCLUSIONS Our findings suggest that considering mood may be important for future CTHC interventions. Because those in the positive mood state at the time of message exposure were more likely to have greater quitting motivations, smoking cessation CTHC interventions may consider strategies to help improve participants' mood when delivering these messages. For those in neutral and negative mood states, focusing on certain message themes (health and motivation to quit) may be more effective than other message themes.
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Affiliation(s)
- Donghee N Lee
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, Division of Health Informatics and Implementation Science, UMass Chan Medical School, Worchester, MA, United States
| | - Elise M Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, MA, United States
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Choi H, Oh J, Kim CK, Ryu H, Ryu Y. Residents need competence not confidence: A retrospective evaluation of the new competency education program for Korean neurology residents. PLoS One 2023; 18:e0290503. [PMID: 37796843 PMCID: PMC10553350 DOI: 10.1371/journal.pone.0290503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/10/2023] [Indexed: 10/07/2023] Open
Abstract
The objective of our study was to scrutinize the learning experiences of Korean neurology residents, with an emphasis on the implications of the novel competency-based curriculum implemented in 2021. We hypothesized that this revised curriculum could modulate residents' cognitive conduct, primarily the manifestation of overconfidence, in distinctive ways across different stages of training. Our investigative framework was three-fold. Initially, we began with a qualitative inquiry involving in-depth interviews with a purposively selected cohort of eight residents from four training sites. This approach facilitated comprehensive insight into their perceptions of their competence and confidence across the continuum of a four-year residency program. Subsequently, we incorporated the K-NEPA13 assessment instrument, administered to the residents and their overseeing supervisors. This stage aimed to dissect potential cognitive biases, particularly overconfidence and consistency, within the resident population. The final study involved a comprehensive survey administered to a group of 97 Korean neurology residents, allowing us to consolidate and validate our preceding findings. Our findings revealed that junior residents portrayed heightened confidence in their clinical capabilities compared to their senior peers. Intriguingly, junior residents also displayed a stronger inclination towards reevaluating their clinical judgments, a behavior we hypothesize is stimulated by the recently introduced competency-based curriculum. We identified cognitive divergence between junior and senior residents, with the latter group favoring more consistent and linear cause-and-effect reasoning, while the former demonstrated receptiveness to introspection and reconsideration. We speculate this adaptability might be engendered by the supervisor assignment protocol intrinsic to the new curriculum. Our study highlights the essentiality of incorporating cognitive behaviors when devising medical education strategies. Acknowledging and addressing these diverse cognitive biases, and instilling a spirit of adaptability, can nurture a culture that persists in continuous learning and self-reflection among trainee doctors.
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Affiliation(s)
- Hojin Choi
- Department of Neurology, Hanyang University, Seoul, Republic of Korea
| | - Jeeyoung Oh
- Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hokyoung Ryu
- Graduate School of Innovation & Technology Management, Hanyang University, Seoul, Republic of Korea
| | - Youngji Ryu
- School of Psychology, Korea University, Seoul, Republic of Korea
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Faro JM, Pbert L, Crawford S, Frisard CF, Pendharkar JA, Sadasivam RS, Geller AC, Mazor KM, Ockene JK. U.S. medical students personal health behaviors, attitudes and perceived skills towards weight management counseling. Prev Med Rep 2022; 27:101814. [PMID: 35656208 PMCID: PMC9152782 DOI: 10.1016/j.pmedr.2022.101814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/28/2022] [Accepted: 04/30/2022] [Indexed: 11/16/2022] Open
Abstract
Physicians' abilities to address obesity in routine care may be affected by their own health behaviors, skills in and attitudes toward weight management counseling (WMC). Gender differences have been noted amongst these factors as well. We examined gender differences in personal health behaviors and predictors of perceived WMC skills and attitudes of medical students enrolled in a WMC trial. Enrollment took place in 2020 and consisted of students from eight U.S. medical schools. Baseline measures included demographics, exercise, and weight management behaviors, WMC attitudes and perceived skills. Descriptive statistics were calculated, and linear mixed models used to assess the effect of personal health behaviors on outcomes of WMC attitudes and perceived skills. Complete data were available for 1145 medical students. More males reported exercising 4 or more days/week (58.6% v. 41.4%), being more likely to monitor their weight (75.6% v. 70.3%) and less likely to intentionally attempt weight loss in the past (50.3% v. 65.3%) compared to females (all p's < 0.05). Exercising 4 or more days per week was positively associated with perceived WMC skills in the adjusted model (β = 0.10, CI 0.06 to 0.14, p < 0.01). Exercise frequency was positively associated with perceived WMC skills, regardless of gender. WMC curriculum may consider focusing on personal health behaviors such as exercise to increase perceived WMC skills.
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Affiliation(s)
- Jamie M. Faro
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
- Corresponding author.
| | - Lori Pbert
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
| | - Sybil Crawford
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
| | - Christine F. Frisard
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
| | - Jyothi A. Pendharkar
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
| | - Rajani S. Sadasivam
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
| | - Alan C. Geller
- Harvard School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Ave., Cambridge, MA, United States
| | - Kathleen M. Mazor
- Meyers Health Care Institute, University of Massachusetts Medical School, 385 Grove St., Worcester, MA, United States
- University of Massachusetts Chan Medical School, Department of Medicine, 55 N Lake Ave., Worcester, MA, United States
| | - Judith K. Ockene
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, 368 Plantation St., Worcester, MA, United States
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Ockene JK, Pbert L, Crawford S, Frisard CF, Pendharkar JA, Sadasivam RS, Faro J, Okuliar C, Eno C, Margo K, Shaw MA, Soleymani T, Stadler DD, Warrier S, White K, Geller AC. Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial. J Gen Intern Med 2021; 36:3000-3007. [PMID: 33835315 PMCID: PMC8034040 DOI: 10.1007/s11606-020-06571-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/29/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Given the rising rates of obesity there is a pressing need for medical schools to better prepare students for intervening with patients who have overweight or obesity and for prevention efforts. OBJECTIVE To assess the effect of a multi-modal weight management curriculum on counseling skills for health behavior change. DESIGN A pair-matched, group-randomized controlled trial (2015-2020) included students enrolled in eight U.S. medical schools randomized to receive either multi-modal weight management education (MME) or traditional weight management education (TE). SETTING/PARTICIPANTS Students from the class of 2020 (N=1305) were asked to participate in an objective structured clinical examination (OSCE) focused on weight management counseling and complete pre and post surveys. A total of 70.1% of eligible students (N=915) completed the OSCE and 69.3% (N=904) completed both surveys. INTERVENTIONS The MME implemented over three years included a web-based course, a role-play classroom exercise, a web-patient encounter with feedback, and an enhanced clerkship experience with preceptors trained in weight management counseling (WMC). Counseling focused on the 5As (Ask, Advise, Assess, Assist, Arrange) and patient-centeredness. MEASUREMENTS The outcome was student 5As WMC skills assessed using an objective measure, an OSCE, scored using a behavior checklist, and a subjective measure, student self-reported skills for performing the 5As. RESULTS Among MME students who completed two of three WMC components compared to those who completed none, exposure was significantly associated with higher OSCE scores and self-reported 5A skills. LIMITATIONS Variability in medical schools requiring participation in the WMC curriculum. CONCLUSIONS This trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management. NIH TRIAL REGISTRY NUMBER R01-194787.
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Affiliation(s)
- Judith K Ockene
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Sybil Crawford
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Christine F Frisard
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jyothi A Pendharkar
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jamie Faro
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | | | - Cassie Eno
- Creighton University School of Medicine, Omaha, NE, USA
| | - Katherine Margo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monica Ann Shaw
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Taraneh Soleymani
- Previously at the University of Alabama, Birmingham, AL and now at Penn State Health, Middletown, PA, USA
| | | | | | | | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA, USA
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Pendharkar JA, Frisard CF, Geller AC, Pbert L, Crawford S, Guck TP, Stadler DD, Ockene J. Weight management counseling experiences of first year medical students before starting medical school and their self-perceived impact on treating patients with obesity. Prev Med Rep 2021; 23:101411. [PMID: 34150473 PMCID: PMC8193141 DOI: 10.1016/j.pmedr.2021.101411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/13/2021] [Accepted: 05/25/2021] [Indexed: 11/19/2022] Open
Abstract
Physicians can play a vital role in counseling patients on overweight and obesity. This secondary analysis examined whether experiences in patient care specific to weight management before starting medical school were associated with students' intentions and confidence to provide weight management counseling (WMC) to patients who have overweight or obesity, and perceived impact as future physicians on patients' motivation to manage weight. First-year medical students (n = 1305) in the entering class of 2020 at eight medical schools nationwide completed questions relating to their prior experiences in patient care and WMC using the 5As. Also assessed were their intentions to treat patients with overweight or obesity, and confidence in counseling patients to help manage their weight. Over half the students (58.3%) who completed the survey had prior experience in patient care and nearly half (47.4%) began medical school with prior WMC experiences. Prior experiences correlated positively with higher confidence in performing WMC and students' intentions to treat patients with overweight or obesity. Given the relatively high rates of exposure to some type of weight management or lifestyle counseling among students before enrolling in medical school, the curriculum could build on established student interest and experience by offering treatment strategies including counseling for patients with overweight and obesity. By making prior experiences advantageous for admission, medical schools could gravitate towards admitting students who have brief but valuable insights about weight management in health care, thus increasing the possibility of filling important gaps.
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Affiliation(s)
- Jyothi A. Pendharkar
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christine F. Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA, USA
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sybil Crawford
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Judith Ockene
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Ashe KM, Geller AC, Pendharkar JA, Pbert L, Crawford S, Clark MA, Frisard CF, Eno CA, Faro J, Ockene JK. Exposure to Weight Management Counseling Among Students at 8 U.S. Medical Schools. Am J Prev Med 2021; 60:711-715. [PMID: 33632652 PMCID: PMC8068621 DOI: 10.1016/j.amepre.2020.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/10/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Clinical guidelines support physician intervention consistent with the Ask, Advise, Assess, Assist, Arrange framework for adults who have obesity. However, weight management counseling curricula vary across medical schools. It is unknown how frequently students receive experiences in weight management counseling, such as instruction, observation, and direct experience. METHODS A cross-sectional survey, conducted in 2017, of 730 third-year medical students in 8 U.S. medical schools assessed the frequency of direct patient, observational, and instructional weight management counseling experiences that were reported as summed scores with a range of 0‒18. Analysis was completed in 2017. RESULTS Students reported the least experience with receiving instruction (6.5, SD=3.9), followed by direct patient experience (8.6, SD=4.8) and observational experiences (10.3, SD=5.0). During the preclinical years, 79% of students reported a total of ≤3 hours of combined weight management counseling instruction in the classroom, clinic, doctor's office, or hospital. The majority of the students (59%-76%) reported never receiving skills-based instruction for weight management counseling. Of the Ask, Advise, Assess, Assist, Arrange framework, scores were lowest for assisting the patient to achieve their agreed-upon goals (31%) and arranging follow-up contact (22%). CONCLUSIONS Overall exposure to weight management counseling was less than optimal. Medical school educators can work toward developing a more coordinated approach to weight management counseling.
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Affiliation(s)
- Karen M Ashe
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jyothi A Pendharkar
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Sybil Crawford
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Melissa A Clark
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Christine F Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Cassie A Eno
- School of Medicine, Creighton University, Omaha, Nebraska
| | - Jamie Faro
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
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Matranga D, Restivo V, Maniscalco L, Bono F, Pizzo G, Lanza G, Gaglio V, Mazzucco W, Miceli S. Lifestyle Medicine and Psychological Well-Being toward Health Promotion: A Cross-Sectional Study on Palermo (Southern Italy) Undergraduates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5444. [PMID: 32731643 PMCID: PMC7432036 DOI: 10.3390/ijerph17155444] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022]
Abstract
(1) Aim: To assess the attitude toward Lifestyle Medicine and healthy behaviours among students in the healthcare area and to demonstrate its association to psychological well-being; (2) Methods: A cross-sectional study is conducted among 508 undergraduates of the University of Palermo (140 (27.6%) in the healthcare area and 368 (72.4%) in the non-healthcare area), during the academic year 2018-2019. Psychological well-being is measured through two dimensions of eudaimonia and hedonia, using the 10-item Hedonic and Eudaimonic Motives for Activities-Revised (HEMA-R) scale, with answers coded on a 7-point scale. The association between demographic and modifiable behavioural risk factors for chronic diseases is assessed through crude and adjusted Odds ratios with 95% confidence intervals; (3) Results: Orientation to both hedonia and eudaimonia is significantly associated to the Mediterranean diet (ORAdj = 2.28; 95% CI = (1.42-3.70)) and drinking spirits less than once a week (ORAdj = 1.89; 95% CI = (1.10-3.27)) and once a week or more (ORAdj = 6.02; 95% CI = (1.05-34.52)), while these conditions occur together less frequently for current smokers (ORAdj = 0.38; 95% CI = (0.18-0.81)). Students inclined to well-being consider healthcare professionals as models for their patients and all people in general (OR = 1.96, 95% CI = (1.28-3.00)); (4) Conclusions: The positive relation found between a virtuous lifestyle and psychological well-being suggests the construction, development and cultivation of individual skills are a means to succeed in counteracting at risk behaviours for health.
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Affiliation(s)
- Domenica Matranga
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Vincenzo Restivo
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy
| | - Filippa Bono
- Department of Economics, Business and Statistics, University of Palermo, 90128 Palermo, Italy;
| | - Giuseppe Pizzo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Giuseppe Lanza
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Valerio Gaglio
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Silvana Miceli
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy;
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Mastrocola MR, Roque SS, Benning LV, Stanford FC. Obesity education in medical schools, residencies, and fellowships throughout the world: a systematic review. Int J Obes (Lond) 2019; 44:269-279. [PMID: 31551484 DOI: 10.1038/s41366-019-0453-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/20/2019] [Accepted: 07/31/2019] [Indexed: 11/09/2022]
Abstract
Obesity is pandemic throughout the world, and there is concern that physicians are inadequately trained to treat their patients with obesity despite its prevalence. This review explores obesity education in medical students, resident, and fellow physicians throughout the world from 2005 to 2018. Previous reviews on obesity education were conducted before 2011, focused solely on medical students, and only explored obesity education in the United States. We systematically searched MEDLINE, EMBASE, PsycINFO, and ERIC databases for studies which included the search terms "obesity education" AND either "medical students", "residency", or "fellowship" that met PICOS (Population, Interventions, Comparators, Outcomes, Study Design) criteria for articles published in English for obesity education and evaluation of outcomes. Our initial search yielded 234 articles, and 27 studies met criteria for our review. We described and analyzed these studies for their study design and graded quality, quantity, and consistency for each measured outcome. We applied an evidence grading system that has been previously applied in the literature in which each outcome measure was graded on a scale from A to D. We evaluated obesity education programs for outcomes regarding implicit and explicit bias, changes in attitude towards obesity, weight change, obesity knowledge, counseling confidence, intent to counsel, and counseling quality. There was a significant degree of heterogeneity in the studies included. While obesity knowledge was most frequently studied, counseling confidence was the only outcome with an overall grade A. There is currently a paucity of obesity education programs for medical students, residents, and fellow physicians in training programs throughout the world despite high disease prevalence. However, these programs often improve outcomes when they are administered. Our review suggests that more obesity education should be administered in undergraduate and graduate medical education to ensure optimal treatment of patients with obesity.
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Affiliation(s)
| | | | - Lauren V Benning
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Fatima Cody Stanford
- Department of Medicine-Division of Endocrinology-Neuroendocrine Department of Pediatrics-Division of Endocrinology, Massachusetts General Hospital, MGH Weight Center, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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