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Schrager S, Williams M, Ward E, Henningfield MF, Yuroff A, Johnson G, Sullivan-Wade L, Hawkins J, Turnquist A. African American women's experiences of menopause: A focus group study. Maturitas 2024; 187:108043. [PMID: 38905863 DOI: 10.1016/j.maturitas.2024.108043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/25/2024] [Accepted: 06/02/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES This study aimed to characterize African American women's experiences of menopause and their interactions with the health care system related to menopausal symptoms. STUDY DESIGN We conducted four focus groups with community-dwelling midlife African American women. MAIN OUTCOMES MEASURES Women who consented to participate completed demographic surveys. Transcripts of the four focus groups (n = 26) were analyzed and themes were elucidated. RESULTS In total, 26 midlife African American women participated in the four focus groups. Participants revealed unmet needs regarding obtaining menopause information from their clinicians. Clinician discussions about menopause tended to be initiated by patients based on their symptoms. Some women reported feeling ignored and/or dismissed by the clinician when they initiated discussions of menopause. Women wanted their clinicians to provide information on menopause, which included receiving information prior to the menopause transition to help them know what to expect. CONCLUSION Women wanted their clinicians to initiate discussions of menopause rather than wait for women to mention symptoms. Prioritizing menopause training for clinicians taking care of midlife African American women may help to improve discussions of menopause.
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Affiliation(s)
- Sarina Schrager
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Wisconsin Department of Health and Family Services, Wisconsin Well Woman Program, Madison, WI, United States of America.
| | - Makeba Williams
- Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St Louis, MO, United States of America
| | - Earlise Ward
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Mary F Henningfield
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Alice Yuroff
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Gale Johnson
- Wisconsin Department of Health and Family Services, Wisconsin Well Woman Program, Madison, WI, United States of America
| | - Lucretia Sullivan-Wade
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Jennifer Hawkins
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
| | - Alyssa Turnquist
- Wisconsin Research and Education Network (WREN), 610 N Whitney Way, Madison, WI 53505, United States of America; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 610 N Whitney Way, Madison, WI 53505, United States of America
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Santoro N, Hendricks N, Gibbs L, Kuhn K, Bradford AP, Mitchell-Leef D. Acceptability and Feasibility of Initiating a Low Fat Eating Plan in Reproductive Aged Women with Obesity. Reprod Sci 2024; 31:2228-2233. [PMID: 38622475 DOI: 10.1007/s43032-024-01542-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
Adverse effects of obesity on reproduction are believed in part due to diet related factors leading to hyperlipidemia and hyperinsulinemia. It is unknown whether administration of a low fat eating plan, regardless of weight loss, will improve reproductive axis function in women with obesity. To develop an acceptable and feasible low fat eating plan for a diverse group of reproductive aged women with obesity. Focus groups to determine preferences and barriers to a planned dietary intervention providing very low fat (22% daily calories from fat) eucaloric food to control fat exposure, but not cause weight loss. Logistics of the intervention and monitoring over three menstrual cycles were discussed. Eighteen women enrolled into 4 different focus groups both live and video, 2 at the University of Colorado and 2 at the Morehouse School of Medicine. All participants expressed interest in implementing a low fat dietary intervention and were further interested in instruction on how to maintain healthy eating habits for future fertility. Provision of ethnically appropriate foods, social support to avoid lapses, and tasty alternatives to high fat foods were considered ideal aspects of a feasible intervention. Incentives and graduated compensation for adherence were considered desirable features. Women with obesity are interested in implementing dietary interventions that may improve their health and fertility. Given the diversity of responses based upon the demographics of our sample, it is important to assess geographical and cultural preferences prior to implementing of a dietary strategy.
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Affiliation(s)
- Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 E 17th Avenue, Academic Office 1 Room 4004, Mail Stop B-198, Aurora, CO, 80045, USA.
| | - Nicola Hendricks
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 E 17th Avenue, Academic Office 1 Room 4004, Mail Stop B-198, Aurora, CO, 80045, USA
| | - Lauren Gibbs
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Katherine Kuhn
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 E 17th Avenue, Academic Office 1 Room 4004, Mail Stop B-198, Aurora, CO, 80045, USA
| | - Andrew P Bradford
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 E 17th Avenue, Academic Office 1 Room 4004, Mail Stop B-198, Aurora, CO, 80045, USA
| | - Dorothy Mitchell-Leef
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
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Taylor-Swanson L, Stoddard K, Fritz J, Anderson B(B, Cortez M, Conboy L, Sheng X, Flake N, Sanchez-Birkhead A, Stark LA, Farah L, Farah S, Lee D, Merkley H, Pacheco L, Tavake-Pasi F, Sanders W, Villalta J, Moreno C, Gardiner P. Midlife Women's Menopausal Transition Symptom Experience and Access to Medical and Integrative Health Care: Informing the Development of MENOGAP. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241268355. [PMID: 39092447 PMCID: PMC11292722 DOI: 10.1177/27536130241268355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 06/14/2024] [Accepted: 07/03/2024] [Indexed: 08/04/2024]
Abstract
Background Individuals with a uterus experience menopause, the cessation of menses, on average at age 51 years in the United States. While menopause is a natural occurrence for most, over 85% of women experience multiple interfering symptoms. Menopausal women face health disparities, including a lack of access to high-quality healthcare and greater disparities are experienced by women who are black, indigenous, and people of color. Some women are turning away from hormone therapy, and some seek integrative health interventions. Objective Some menopausal women who seek healthcare do not receive it as they lack access to medical and integrative healthcare providers. A potential solution to this problem is a medical group visit (MGV), during which a provider sees multiple patients at once. The aims of this study were to gather women's opinions about the menopause, provider access, and conventional and integrative health interventions for later use to develop a menopause MGV. Methods We conducted a Community Engagement Session and a Return of Results (RoR) with midlife women to learn about their menopause experiences, barriers and facilitators to accessing health providers, and their interest in and suggestions for designing a future integrative MGV (IMGV). Thematic qualitative research methods were used to summarize session results. Results Nine women participated in the Session and six attended the RoR. Participants were well-educated and diverse in race and ethnicity. Themes included: an interest in this topic; unfamiliar medical terms; relevant social factors; desired whole person care; interest in integrative health; barriers and facilitators to accessing healthcare. The group expressed interest in ongoing participation in the future process of adapting an IMGV, naming it MENOGAP. Conclusion These findings highlight the importance of stakeholder engagement before designing and implementing MENOGAP and the great need among midlife women for education about the menopausal transition, integrative self-care, and healthcare.
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Affiliation(s)
| | - Kari Stoddard
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Julie Fritz
- College of Health, University of Utah, Salt Lake City, UT, USA
| | | | - Melissa Cortez
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Lisa Conboy
- Instructor in Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Xiaoming Sheng
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Naomi Flake
- Utah Clinical and Translational Science Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Louisa A. Stark
- Utah Clinical and Translational Science Institute, University of Utah, Salt Lake City, UT, USA
- Department of Human Genetics, University of Utah, Salt Lake City, UT, USA
| | - Luul Farah
- University of Utah, Salt Lake City, UT, USA
| | - Sara Farah
- University of Utah, Salt Lake City, UT, USA
| | | | - Heather Merkley
- College of Health Professions, Weber State University, Ogden, UT, USA
| | | | | | | | | | - Camille Moreno
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Paula Gardiner
- University of Massachusetts Medical School and Director of Primary Care Implementation Research, Cambridge Health Alliance, Cambridge, MA, USA
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Kracht CL, St Romain J, Hardee JC, Santoro N, Redman LM, Marlatt KL. "Weight loss is my goal and being healthy is my goal… I can get over the hot flashes": a qualitative exploration of menopausal transition experiences and preferences for weight management among White women. Menopause 2023; 30:1022-1032. [PMID: 37699233 PMCID: PMC10528173 DOI: 10.1097/gme.0000000000002248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
OBJECTIVES A qualitative research study design was used to (1) describe experiences of White women during the menopausal transition, and (2) identify barriers and facilitators for participating in a lifestyle program targeting weight management. METHODS Perimenopausal and postmenopausal White women who self-reported a desire to lose or maintain weight participated in focus groups. Women were queried about their past diet, exercise, and weight management practices; menopausal transition; and specific components and considerations for developing a lifestyle program for weight management. Thematic analysis was conducted on coded transcripts and four main themes emerged, each containing three to six subthemes. RESULTS Twenty-eight White women (age 54 ± 3 y, body mass index 31.4 ± 9.5 kg/m 2 ) were enrolled. Overall, women felt menopause was a major life event that coincided with weight gain and frustrating body changes. Women already engaged in many different types of exercises and diets to lose weight. Women also talked to healthcare professionals about menopause but were disappointed in the support they received. Women were interested in a lifestyle program that included menopause-specific education, which focused on results beyond weight, which was flexible to their busy lifestyle, and which provided opportunities to build camaraderie among other women experiencing menopause. CONCLUSIONS This cohort of White women were interested in receiving menopause information and improving their overall health as part of a lifestyle program targeting weight management during this transition. Building camaraderie with other women affected by menopause is important to women, as is creating a lifestyle program that is flexible with daily life.
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Affiliation(s)
| | | | - Julie C Hardee
- From the Pennington Biomedical Research Center, Baton Rouge, LA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Leanne M Redman
- From the Pennington Biomedical Research Center, Baton Rouge, LA
| | - Kara L Marlatt
- From the Pennington Biomedical Research Center, Baton Rouge, LA
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Faubion SS, Enders F, Hedges MS, Chaudhry R, Kling JM, Shufelt CL, Saadedine M, Mara K, Griffin JM, Kapoor E. Impact of Menopause Symptoms on Women in the Workplace. Mayo Clin Proc 2023:S0025-6196(23)00112-X. [PMID: 37115119 DOI: 10.1016/j.mayocp.2023.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/20/2023] [Accepted: 02/16/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To evaluate the impact of menopause symptoms on work outcomes and to assess the estimated economic impact. PATIENTS AND METHODS Women aged 45 to 60 years receiving primary care at 1 of the 4 Mayo Clinic sites were invited to participate in a survey study (Hormones and ExpeRiences of Aging) from March 1 through June 30, 2021. A total of 32,469 surveys were sent, with 5219 responses (16.1% response rate). Of the 5219 respondents, 4440 (85.1%) reported current employment information and were included in the study. The primary outcome was self-reported adverse work outcomes related to menopause symptoms assessed by the Menopause Rating Scale (MRS). RESULTS The mean age of the 4440 participants was 53.9±4.5 years, with the majority being White (4127 [93.0%]), married (3398 [76.5%]), and educated (2632 [59.3%] college graduate or higher); the mean total MRS score was 12.1, signifying moderate menopause symptom burden. Overall, 597 women (13.4%) reported at least one adverse work outcome due to menopause symptoms; 480 women (10.8%) reported missing work in the preceding 12 months (median, 3 days missed). The odds of reporting an adverse work outcome increased with increasing menopause symptom severity; women in the highest quartile of total MRS scores were 15.6 (95% CI, 10.7 to 22.7; P<.001) times more likely to have an adverse work outcome vs those in the first quartile. Based on workdays missed due to menopause symptoms, we estimate an annual loss of $1.8 billion in the United States. CONCLUSION This large cross-sectional study identified a major negative impact of menopause symptoms on work outcomes and the need to improve medical treatment for these women and make the workplace environment more supportive. Additional studies are needed to confirm these findings in larger and more diverse groups of women.
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Affiliation(s)
- Stephanie S Faubion
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN.
| | - Felicity Enders
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Mary S Hedges
- Division of Community Internal Medicine, Mayo Clinic, Jacksonville, FL
| | - Rajeev Chaudhry
- Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN; Division of Community Internal Medicine, Mayo Clinic Health System, Eau Claire, WI
| | - Juliana M Kling
- Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN; Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - Chrisandra L Shufelt
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN
| | - Mariam Saadedine
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN
| | - Kristin Mara
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Joan M Griffin
- Division of Health Care Delivery Research and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Ekta Kapoor
- Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN; Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
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Li Q, Gu J, Huang J, Zhao P, Luo C. "They see me as mentally ill": the stigmatization experiences of Chinese menopausal women in the family. BMC Womens Health 2023; 23:185. [PMID: 37076835 PMCID: PMC10116657 DOI: 10.1186/s12905-023-02350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/12/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Menopausal women are regarded as "abnormal people" in China and are often discriminated against and ostracized, especially in the privacy of their homes. However, research on the stigmatization of menopausal women in China is limited. The aim of this study is to explore and describe the stigmatization experiences of Chinese menopausal women in the family and their feelings about these experiences. METHODS A phenomenological qualitative research design involving in-depth semi-structured interviews was selected. Our data analysis adopted Colaizzi's methodology. RESULTS Fourteen menopausal women participated in this study. Four themes and 12 subthemes emerged: (1) violent treatment (verbal and physical violence); (2) lack of attention and companionship (lack of understanding of physical and psychological suffering, neglect of the value of labour and difficulty finding someone to talk to and accompany them); (3) coping struggles (keeping quiet, fighting back, changing inappropriate perceptions and developing a menopausal transition management plan); and (4) despair (deep-rooted perceptions, restrictions on travel and consumption, and unknown "healing" times). CONCLUSION Our results suggest that Chinese menopausal women suffer physically and mentally within their families. The stigma of menopause is both a symptom of the broad societal lack of knowledge regarding menopause and a reflection of the patriarchal oppression of women in a specific cultural context. Accordingly, this study can help menopausal women and society in general better understand the former's stigmatization experiences and amplify their inner voices. Moreover, it can serve as a reference for the formulation of menopause-related health policies in China and for advocating and promoting humanistic care for menopausal women.
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Affiliation(s)
- Qiong Li
- School of Public Administration, Hohai University, Nanjing, 211100, China
| | - Jintu Gu
- Department of Sociology, Hohai University, Nanjing, China.
- Research Center for Environment and Society, Hohai University, Nanjing, China.
- Yangtze Institute for Conservation and High-quality Development, Jiangsu Research Base, Nanjing, China.
| | - Jianyuan Huang
- School of Public Administration, Hohai University, Nanjing, 211100, China
| | - Pei Zhao
- Jiangsu Province Hospital, Nanjing, 211100, China.
| | - Chenliang Luo
- Shanghai Pudong New Area Tax Bureau, State Taxation Administration, Shanghai, 200120, China
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Tong C, Meng Y, Li T, Luo Y. High levels of physical activity are associated with a reduced likelihood of depressive symptoms in postmenopausal women. Women Health 2023; 63:308-318. [PMID: 36915263 DOI: 10.1080/03630242.2023.2188100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Depressive symptoms in postmenopausal women are a significant concern, but studies evaluated their relationship with menopausal symptoms and physical activity are limited. This cross-sectional study used the scale of the 9-item Patient Health Questionnaire (PHQ-9) and the modified Kupperman Index (KMI) to investigate the relationship between depressive symptoms, menopausal symptoms, and physical activity in postmenopausal women in Hunan Province, using cluster random sampling, and face-to-face interviews with women aged 50-64 years. The moderate (aOR = 2.242, 95 percent CI [1.646-3.052], P < .001) and severe menopausal symptoms (aOR = 3.654, 95 percent CI [1.754-7.611], P = .001), and low-level physical activity (aOR = 1.380, 95 percentCI [1.023-1.826], P = .035) may increase the risk of depressive symptoms. High levels of physical activity were associated with a decreased likelihood of depressive symptoms, but only when participants had no complaints of menopausal symptoms (aOR = 0.375, 95 percent CI [0.161-0.877], P = .024). This study provides a new result for the mental health of postmenopausal women and provides a reference for further related research.
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Affiliation(s)
- Chenxi Tong
- Xiangya Nursing School, Central South University, No. 172 of Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Yanting Meng
- Xiangya Nursing School, Central South University, No. 172 of Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Ting Li
- Xiangya Nursing School, Central South University, No. 172 of Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
| | - Yang Luo
- Xiangya Nursing School, Central South University, No. 172 of Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China
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Dupuy-McCauley K, Benzo R, Barwise A. Designing a program to support weight loss for patients attending the sleep medicine clinic: a qualitative study. J Clin Sleep Med 2023; 19:459-471. [PMID: 36458729 PMCID: PMC9978432 DOI: 10.5664/jcsm.10354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 12/04/2022]
Abstract
STUDY OBJECTIVES Excess body weight is the most important risk factor in sleep-disordered breathing. Weight loss is a treatment alternative to positive airway pressure therapy, but there is a knowledge gap of what is feasible, acceptable, and sustainable in this population. We seek to add the voices of sleep medicine patients and providers to the medical literature to understand what makes this population unique when considering weight loss, and what we can do differently to create more sustainable weight loss interventions. METHODS We conducted one-on-one semistructured interviews with 12 patients with obstructive sleep apnea/obesity hypoventilation syndrome and obesity and with 9 sleep medicine providers regarding previous weight loss efforts, perceptions of barriers to and facilitators of weight loss, and potential components of a program to support those with sleep apnea and excess weight. RESULTS Patients indicated they appreciated direct conversation with their sleep physician regarding weight loss and providers felt the patient population was generally very receptive to weight loss conversations. Patients emphasized the most important aspects of a future weight loss program would be personalized diet, exercise, accountability, integration of technology, and an individualized approach to addressing the psychological aspects of eating. CONCLUSIONS This is a unique population of patients who are very receptive to conversations about weight loss. We plan to use this data to inform a future weight loss program based in health coaching to address the specific needs of this population. CITATION Dupuy-McCauley K, Benzo R, Barwise A. Designing a program to support weight loss for patients attending the sleep medicine clinic: a qualitative study. J Clin Sleep Med. 2023;19(3):459-471.
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