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APHA Scientific Session and Event Listing

Thomas Tai-Seale, DrPH, School of Rural Public Health, Texas A&M Health Science Center, 1266 TAMU, College Station, TX 77843-1266, 979-458-8058, ttaiseale@srph.tamhsc.edu, Ming Tai-Seale, PhD, MPH, Health Policy and Management, Texas A&M Health Science Center, 1266 TAMU, College Station, TX 77843, and Weimin Zhang, MS, Department of Statistics, Texas A&M University, 3143 TAMU, College Station, TX 77843-3143.

Overweight is a national epidemic affecting all age groups. Over 70% of older Americans are overweight or obese, increasing their health risks. Health-professional organizations recommend that all adult patients be screened and offered intensive counseling and behavioral interventions for weight loss as needed. NHLBI Clinical Guidelines recommend that weight status be assessed at every opportune patient encounter followed by appropriate counseling and treatment. These guidelines apply to older patients when benefit is expected, and benefit has been demonstrated. Given this, we asked: Do older patients communicate with their physicians about weight loss? Who initiates and how long does the conversation last? Does the patient's mental health matter? What about provider characteristics? What does a typical discussion look like? We used 350 videotaped older patient visits to 35 physicians in three different primary care settings along with patient SF-36 scores to answer these questions and assess communication and quality of care. Logit-type regression modeled covariate influence on discussion probability, and parametric survival Weibull regression modeled differences in discussion time. Content analysis examined patient-physician discourse. We found a general disregard for discussing and treating overweight and obesity among older Americans and a lack of guideline adherence. Nineteen percent of our sample was visibly obese. Weight loss, however, was rarely discussed and decreased among older patients. On average, discussions lasted 37 seconds and rarely concluded satisfactorily. Mental health also affected discussion.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

1 Evaluate doctor-older patient communication on weight loss.
• Formulate recommendations to improve quality of care and communication.

Keywords: Obesity, Communication

Presenting author's disclosure statement:

Not Answered