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Tarchi L, Buonocore TM, Selvi G, Ricca V, Castellini G. Online content on eating disorders: a natural language processing study. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024:1-10. [PMID: 39041376 DOI: 10.1080/17538068.2024.2379160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND Online content can inform the personal risk of developing an eating disorder, and it can influence the time and motivation to seek treatment. Patients routinely seek information online, and access to information is crucial for both prevention and treatment. The primary aim of the current study was to quantify the readability scores of online content on eating disorders using natural language processing algorithms, across two languages: English and Italian. METHODS Unique terms related to single diagnoses were searched using Google®. The content available on Wikipedia was also assessed. Readability was defined according to the Flesch Readability Ease (FRE) and the Rate Readability Index (RIX). The scientific support of retrieved content and the authoritativeness of sources were measured through standardized variables. RESULTS In Italian, online content was more likely published by private psychotherapy institutes or by websites that promote diet-advice or weight-loss. In both languages, the most readable content was on Anorexia Nervosa (RIX 4.18, FRE-en 59.6, FRE-it 41.69), Bulimia Nervosa (RIX 3.99, FRE-en 66.27, FRE-it 39.66) or Binge Eating (RIX 4.01, FRE-en 68.10, FRE-it 38.62). English sources consistently had more references than Italian pages (range 35-182, vs 1-163, respectively). and had a higher percentage of citations available in the target language. The content of these references was mainly reflective of peer-reviewed or clinical manuals. CONCLUSION Attention should be given to developing online content for Muscle Dysmorphia and Orthorexia Nervosa, as well as improving the overall readability of online content on eating disorders, especially for languages other than English.
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Affiliation(s)
- Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Tommaso Mario Buonocore
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Giulia Selvi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Khamseh ME, Emami Z, Iranpour A, Mahmoodian R, Amouei E, Tizmaghz A, Moradi Y, Baradaran HR. Attitude and Belief of Healthcare Professionals Towards Effective Obesity Care and Perception of Barriers; An Updated Systematic Review and Meta-analysis. ARCHIVES OF IRANIAN MEDICINE 2023; 26:529-541. [PMID: 38310408 PMCID: PMC10862058 DOI: 10.34172/aim.2023.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/03/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Obesity is a serious chronic disease that adversely affects health and quality of life. However, a significant percentage of people do not participate in or adhere to weight loss programs. Therefore, a multidisciplinary approach is needed to identify critical barriers to effective obesity management and to examine health practitioners' attitudes and behaviors towards effective obesity treatment. METHODS This systematic review was conducted in accordance with PRISMA 2020. Eligible studies were identified through a systematic review of the literature using Medline, Scopus, Cochrane, Google Scholar, Web of Science, and Embase databases from January 1, 2011 to March 2, 2021. RESULTS A total of 57 articles were included. Data on 12663 physicians were extracted from a total of 35 quantitative articles. Some of the most commonly perceived attitude issues included "obesity has a huge impact on overall health", "obesity is a disease" and "HCPs are to blame". Health professionals were more inclined to believe in "using BMI to assess obesity," "advice to increase physical activity," and "diet/calorie reduction advice." The major obstacles to optimal treatment of obesity were "lack of motivation", "lack of time" and "lack of success". CONCLUSION Although the majority of health care professionals consider obesity as a serious disease which has a large impact on overall health, counseling for lifestyle modification, pharmacologic or surgical intervention occur in almost half of the visits. Increasing the length of physician visits as well as tailoring appropriate training programs could improve health care for obesity.
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Affiliation(s)
- Mohammad E. Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Emami
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Aida Iranpour
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Mahmoodian
- Department of Internal Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Erfan Amouei
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Adnan Tizmaghz
- Department of Surgery, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hamid R Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK
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de Pooter N, van den Eynde E, Raat H, Seidell JC, van den Akker EL, Halberstadt J. Perspectives of healthcare professionals on facilitators, barriers and needs in children with obesity and their parents in achieving a healthier lifestyle. PEC INNOVATION 2022; 1:100074. [PMID: 37213756 PMCID: PMC10194305 DOI: 10.1016/j.pecinn.2022.100074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 05/23/2023]
Abstract
Objective To explore the perspectives of healthcare professionals (HCPs) within an integrated care approach on the facilitators, barriers and needs in children with obesity and their parents in achieving a healthier lifestyle. Methods Semi-structured interviews were conducted with eighteen HCPs working within a Dutch integrated care approach. The interviews were analyzed by performing a thematic content analysis. Results Main facilitators identified by HCPs were support from parents and the social network. Main barriers were first and foremost family's lack of motivation, which was singled out as a precondition for starting the behavior change process. Other barriers were child's socio-emotional problems, parental personal problems, lack of parenting skills, parental lack of knowledge and skills regarding a healthier lifestyle, parental lack of problem awareness and HCP's negative attitude. To overcome these barriers, main needs that HCPs suggested were a tailored approach in healthcare and a supportive HCP. Conclusion The HCPs identified the breadth and complexity of underlying factors of childhood obesity, of which the family's motivation was pointed out as a critical factor to address. Innovation Understanding the patient's perspective is important for HCPs to provide the tailored care needed to address the complexity of childhood obesity.
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Affiliation(s)
- Naomi de Pooter
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
- Corresponding author at: Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam Public Health Institute, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Emma van den Eynde
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jacob C. Seidell
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | | | - Jutka Halberstadt
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
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Abstract
OBJECTIVE This study explores patients' acceptance of obesity as a chronic disease. DESIGN Cross-sectional, qualitative study using semistructured phone interviews. SETTING The study was conducted in specialty and primary care clinics from a single central tertiary hospital in Lebanon. Recruitment took place between February and March 2021. PARTICIPANTS AND METHODS 25 adult patients with overweight or obesity were interviewed and the interviews were analysed thematically. RESULTS Four themes emerged: (1) patients' knowledge and awareness of obesity are based on their own experience; (2) there is ambivalence or conditional acceptance of obesity as a chronic disease; and patients with overweight or obesity perceived (3) that the role of physicians in obesity management is related to complications and (4) that obesity management is as simple as eating less and exercising more. CONCLUSIONS The study shows the studied population's ambivalence in accepting obesity as a chronic disease. Individuals with overweight or obesity considered the role of the healthcare professional in obesity conditional on morbid obesity and the presence of medical complications of obesity. Findings of this study advocate for educational campaigns about the nature of obesity as a chronic disease and the role of healthcare professionals in obesity management.
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Affiliation(s)
- Natally AlArab
- Family Medicine, American University of Beirut, Beirut, Lebanon
| | - Jumana Antoun
- Family Medicine, American University of Beirut, Beirut, Lebanon
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McHale CT, Laidlaw AH, Cecil JE. Predictors of weight discussion in primary care consultations: A multilevel modeling approach. PATIENT EDUCATION AND COUNSELING 2022; 105:502-511. [PMID: 34253384 DOI: 10.1016/j.pec.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/14/2021] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To understand how primary care weight-related communication processes are influenced by individual differences in primary care practitioner (PCP) and patient characteristics and communication use. METHODS Two multilevel logistic regression models were calculated to predict the occurrence of 1) weight-related discussion and 2) weight-related consultation outcomes. Coded communication data (Roter Interaction Analysis System) from 218 video-recorded consultations between PCPs and patients with overweight and obesity in Scottish primary care practices were combined with their demographic data to develop the multilevel models. RESULTS Weight-related discussions were more likely to occur when a greater proportion of PCP's total communication was partnership building and activating communication. More discrete weight discussions during a consultation predicted weight-related consultation outcomes. Patient BMI positively predicted both weight-related discussion and consultation outcomes. CONCLUSION This work demonstrates that multilevel modeling is a viable approach to investigating coded primary care weight-related communication data and that it can provide insight into the impact that various patient and PCP factors have on these communication processes. PRACTICE IMPLICATIONS Through the increased use of partnership building and activating communications, and by engaging in shorter, but more frequent, discussions about patient weight, PCPs may better facilitate weight-related discussion and weight-related consultation outcomes for their patients.
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Affiliation(s)
- Calum T McHale
- School of Medicine, University of St Andrews, St Andrews, UK.
| | - Anita H Laidlaw
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Joanne E Cecil
- School of Medicine, University of St Andrews, St Andrews, UK
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Critchlow N, Rosenberg G, Rumgay H, Petty R, Vohra J. Weight assessment and the provision of weight management advice in primary care: a cross-sectional survey of self-reported practice among general practitioners and practice nurses in the United Kingdom. BMC FAMILY PRACTICE 2020; 21:111. [PMID: 32552861 PMCID: PMC7304118 DOI: 10.1186/s12875-020-01184-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/09/2020] [Indexed: 12/26/2022]
Abstract
Background Although primary care settings provide a large-scale and high-reach opportunity for weight management and obesity prevention, the proportion of adults in the United Kingdom (UK) who report receiving weight management advice is limited. This study examines the self-reported frequency of assessing weight and providing weight management advice by General Practitioners (GPs) and Practice Nurses (PNs) working in primary care in the UK, and differences by practitioner characteristics. Methods Cross-sectional survey with GPs and PNs in the UK (n = 2020), conducted January–March 2017. A mock consultation exercise assessed what factors led to calculating a patient’s Body Mass Index (BMI) and whether weight management advice was given after determining the patient had an obese BMI. For all patients, practitioners were asked how often they calculated BMI, how often they gave weight management advice to patients with an obese BMI, and how often they utilised different advice or referral options (each: Always/Often vs. Less often/Never). Binary logistic regressions examined whether frequency of assessing weight and providing advice was associated with practitioner characteristics. Results In the mock consultation, physical cues (40%) were most likely to prompt calculation of BMI, and half of practitioners (56%) provided weight management advice after determining the patient had an obese BMI, with GPs less likely to do so than PNs (Odds Ratio [OR] = 0.59, 95% CI: 0.47–0.75). Half of practitioners (58%) said they calculated the BMI of all patients Always/Often, with GPs less likely to do so than PNs (OR = 0.27, 95% CI: 0.21–0.34). Three quarters (78%) said they provided weight management advice to patients with an obese BMI Always/Often, with GPs less likely to do so than PNs (OR = 0.63, 95% CI: 0.47–0.85). Weight management advice was provided more frequently than referrals, particularly suggesting increased physical activity (93%) and diet modification (89%). Conclusions Consistent with previous research, the findings suggest that opportunities to provide weight management advice in primary care, including to patients with an obese BMI, are potentially missed. Future research should test alternative mechanisms to increase weight assessment and advice provision, examine the effectiveness of advice frequently given, and seek solutions to reported barriers for providing weight management advice.
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Affiliation(s)
- Nathan Critchlow
- Cancer Policy Research Centre, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK. .,Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK.
| | - Gillian Rosenberg
- Cancer Policy Research Centre, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK
| | - Harriet Rumgay
- Cancer Intelligence, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK
| | - Robert Petty
- Cancer Policy Research Centre, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK
| | - Jyotsna Vohra
- Cancer Policy Research Centre, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK
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McHale CT, Laidlaw AH, Cecil JE. Primary care patient and practitioner views of weight and weight-related discussion: a mixed-methods study. BMJ Open 2020; 10:e034023. [PMID: 32156764 PMCID: PMC7064140 DOI: 10.1136/bmjopen-2019-034023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To understand the beliefs that primary care practitioners (PCPs) and patients with overweight and obesity have about obesity and primary care weight management in Scotland. SETTING Seven National Health Service (NHS) Scotland primary care centres. PARTICIPANTS A total of 305 patients and 14 PCPs (12 general practitioners; two practice nurses) participated. DESIGN AND METHODOLOGY A cross-sectional mixed-methods study. PCPs and patients completed questionnaires assessing beliefs about obesity and primary care weight communication and management. Semi-structured interviews were conducted with PCPs to elaborate on questionnaire topics. Quantitative and qualitative data were synthesised to address study objectives. RESULTS (1) Many patients with overweight and obesity did not accurately perceive their weight or risk of developing weight-related health issues; (2) PCPs and patients reported behavioural factors as the most important cause of obesity, and medical factors as the most important consequence; (3) PCPs perceive their role in weight management as awareness raising and signposting, not prevention or weight monitoring; (4) PCPs identify structural and patient-related factors as barriers to weight communication and management, but not PCP factors. CONCLUSIONS Incongruent and/or inaccurate beliefs held by PCPs and patient may present barriers to effective weight discussion and management in primary care. There is a need to review, standardise and clarify primary care weight management processes in Scotland. Acknowledging a shared responsibility for obesity as a disease may improve outcomes for patients with overweight and obesity.
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Affiliation(s)
- Calum T McHale
- School of Medicine, University of St Andrews, St Andrews, Fife, UK
| | - Anita H Laidlaw
- School of Medicine, University of St Andrews, St Andrews, Fife, UK
| | - Joanne E Cecil
- School of Medicine, University of St Andrews, St Andrews, Fife, UK
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