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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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Knowledge, Attitude and Health Practice towards Cardiovascular disease in Health care providers: A Systematic Review. Curr Probl Cardiol 2022:101206. [PMID: 35460686 DOI: 10.1016/j.cpcardiol.2022.101206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
The prevalence of cardiovascular disorders among healthcare providers have been increasing in the past few years and research conducted in this aspect have identified various risk factors that affect cardiovascular health: like shift work, high stress, anxiety, work environment, obesity, high basal metabolic index, and others. PRISMA guidelines were followed and data search was conducted on PubMed, PMC, MEDLINE, and Google Scholar wherein the identification and screening led to 31 selected studies on identification of knowledge, perception and attitude of the healthcare providers regarding their cardiovascular disorders. Results reveal that knowledge level even although high in healthcare providers regarding their cardiovascular health, the attitude or perception differs among them. Lack of time, stigma, fear of unknown, access to healthcare, not wishing to burden co-workers are some of the identified factors which are affecting their decision making regarding proper actions to be taken to address their cardiovascular issues.
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Hersch DE, Uy MJA, Ngaw SM, Loth KA. Primary care providers' perspectives on initiating childhood obesity conversations: a qualitative study. Fam Pract 2021; 38:460-467. [PMID: 33677525 PMCID: PMC8414925 DOI: 10.1093/fampra/cmaa144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Primary care physicians (PCPs) are in a critical position for identifying, preventing and treating childhood obesity. However, a one-size-fits-all approach does not exist for having conversations about weight with families. A better understanding of how PCPs can address paediatric patients' weight concerns is needed in order to develop effective guidelines and trainings. OBJECTIVE To describe PCPs preferences and behaviours regarding weight-related conversations with paediatric patients' and their families. METHODS Twenty PCPs affiliated with the University of Minnesota, USA, were recruited to participate in semi-structured interviews. Transcripts were analysed using inductive thematic analysis. RESULTS PCP's identified well-child visits as the most appropriate time for weight-related discussions with families. Physicians described what approaches/elements they perceived to work best during conversations: collaboration, empathy, health-focused and objective measures. CONCLUSIONS Overall, PCPs were more comfortable with weight-related discussions during annual well-child visits and rarely initiated them during an acute visit or the first encounter with a patient. Objective measures, such as growth charts, were often utilized to start discussions. Considering a large proportion of well-child visits are missed, alternative opportunities to have discussions about healthy lifestyle behaviours should be explored. The integral role PCPs play in paediatric obesity warrants further research.
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Affiliation(s)
- Derek E Hersch
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Marc James A Uy
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Croghan IT, Ebbert JO, Njeru JW, Rajjo TI, Lynch BA, DeJesus RS, Jensen MD, Fischer KM, Phelan S, Kaufman TK, Schroeder DR, Rutten LJF, Crane SJ, Tulledge-Scheitel SM. Identifying Opportunities for Advancing Weight Management in Primary Care. J Prim Care Community Health 2020; 10:2150132719870879. [PMID: 31496342 PMCID: PMC6734618 DOI: 10.1177/2150132719870879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Much has been written about the patients' perspective concerning weight management in health care. The purpose of this survey study was to assess perspectives of primary care providers (PCPs) and nurses toward patient weight management and identify possible areas of growth. Patients and Methods: We emailed a weight management-focused survey to 674 eligible participants (437 [64.8%] nurses and 237 [35.2%] PCPs) located in 5 outpatient primary care clinics. The survey focused on opportunities, practices, knowledge, confidence, attitudes, and beliefs. A total of 219 surveys were returned (137 [62.6%] from nurses and 82 [34.4%] from PCPs). Results: Among 219 responders, 85.8% were female and 93.6% were white non-Hispanic. In this study, PCPs and nurses believed obesity to be a major health problem. While PCPs felt more equipped than nurses to address weight management (P < .001) and reported receiving more training than nurses (50.0% vs 17.6%, respectively), both felt the need for more training on obesity (73.8% and 79.4%, respectively). Although, PCPs also spent more patient contact time providing weight management services versus nurses (P < .001), the opportunity/practices score was lower for PCPs than nurses (-0.35 ± 0.44 vs -0.17 ± 0.41, P < .001) with PCPs more likely to say they lacked the time to discuss weight and they worried it would cause a poor patient-PCP relationship. The knowledge/confidence score also differed significantly between the groups, with nurses feeling less equipped to deal with weight management issues than PCPs (-0.42 ± 0.43 vs -0.03 ± 0.55, P < .001). Neither group seemed very confident, with those in the PCP group only answering with an average score of neutral. Conclusion: By asking nurses and PCP general questions about experiences, attitudes, knowledge, and opinions concerning weight management in clinical care, this survey has identified areas for growth in obesity management. Both PCPs and nurses would benefit from additional educational training on weight management.
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Okello S, Amir A, Bloomfield GS, Kentoffio K, Lugobe HM, Reynolds Z, Magodoro IM, North CM, Okello E, Peck R, Siedner MJ. Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa. Prog Cardiovasc Dis 2020; 63:149-159. [PMID: 32035126 PMCID: PMC7237320 DOI: 10.1016/j.pcad.2020.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 02/07/2023]
Abstract
As longevity has increased for people living with HIV (PLWH) in the United States and Europe, there has been a concomitant increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity in this population. Whereas the availability of HIV antiretroviral therapy has resulted in dramatic increases in life expectancy in sub-Saharan Africa (SSA), where over two thirds of PLWH reside, if and how these trends impact the epidemiology of CVD is less clear. In this review, we describe the current state of the science on how both HIV and its treatment impact CVD risk factors and outcomes among PLWH in sub-Saharan Africa, including regional factors (unique to SSA) likely to differentiate these relationships from the global North. We then outline how current regional guidelines address CVD prevention among PLWH and which clinical and structural interventions are best poised to confront the co-epidemics of HIV and CVD in the region. We conclude with a discussion of key research gaps that need to be addressed to optimally develop an actionable public health response.
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Affiliation(s)
- Samson Okello
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Medicine, University of Virginia Health Systems, Charlottesville, VA, USA.
| | - Abdallah Amir
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Neurology, Mayo Clinic, Phoenix/Scottsdale, AZ, USA
| | - Gerald S Bloomfield
- Duke Clinical Research Institute, Durham, NC, USA; Duke Global Health Institute, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA
| | - Katie Kentoffio
- Department of Cardiology, University of California San Francisco, San Francisco, CA, USA
| | - Henry M Lugobe
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Zahra Reynolds
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Itai M Magodoro
- Departments of Medicine & Diagnostic Radiology, McGill University Health Center, Montreal, QC, Canada; Division of Cardiology, University of Cape Town, Cape Town, South Africa
| | - Crystal M North
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Robert Peck
- The Center for Global Health, Weill Cornell Medical Center for Global Health, New York, USA; Department of Internal Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Mark J Siedner
- Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Carlos S, Rico-Campà A, de la Fuente-Arrillaga C, Echavarri M, Fernandez-Montero A, Gea A, Salazar C, Martínez-González MA. Do healthy doctors deliver better messages of health promotion to their patients?: Data from the SUN cohort study. Eur J Public Health 2020; 30:466-472. [DOI: 10.1093/eurpub/ckaa019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Abstract
Background
Healthy lifestyle adherence is associated with lower chronic disease morbidity/mortality. The role of doctors, as counselors and role models, is essential. Among physicians participating in a prospective cohort, we investigated the behavioral counseling on diet and lifestyle provided to their patients in association with their own personal behaviors.
Methods
We assessed 890 doctors aged ≤65 years participating in the ‘Seguimiento Universidad de Navarra’ (SUN) cohort, who replied to an online questionnaire regarding their practices on behavioral counseling and drug prescription to their patients. Data were combined with previous baseline information on their personal healthy habits.
Results
Among doctors, 31% reported <10 min per visit; 73% counseled 60–100% of their patients on smoking cessation, 58% on physical activity, 54% on weight control, 51% on healthy nutrition, 44% on alcohol avoidance/reduction and 28% recommended alcohol moderate consumption. The percentage of doctors that counseled 100% of their patients about lifestyle was 43% for smoking cessation, 15% for exercise and 13% for weight control and nutrition. Better doctor’s adherence to the Mediterranean dietary pattern was associated with more frequent and longer nutrition counseling. Higher practice of physical activity was associated with longer time on counseling about exercise to their patients. Among doctors both current and former smoking were inversely associated with the frequency and duration of their smoking cessation/avoidance counseling practices.
Conclusions
Personal behavioral changes among doctors and better training of medical doctors on a personal healthy diet and lifestyle are likely to contribute to improve the behavioral counseling given to patients.
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Affiliation(s)
- Silvia Carlos
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
| | - Anaïs Rico-Campà
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
- Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - Carmen de la Fuente-Arrillaga
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
- Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - María Echavarri
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Alejandro Fernandez-Montero
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
- Department of Occupational Medicine, University of Navarra, Pamplona, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
- Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - Camino Salazar
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria, Sanidad de Castilla y Leon (SACYL), Palencia, Spain
| | - Miguel Angel Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
- Centro de Investigación Biomédica en Red Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
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