Correlates and determinants of nurse practitioners' self-efficacy in adult obesity treatment and weight management tactics

Obesity incidence and prevalence has increased dramatically since the 1970's. Nurse practitioners, as primary health care providers, are in an excellent position to intervene in the obesity epidemic. However, little is known about the factors that influence nurse practitioners' practice in the management of adult obesity. The purpose of this presentation is to discuss the findings of a study that investigated the relationships among factors that impact, explain, and predict nurse practitioners' perceived self-efficacy in obesity treatment. To better understand these relationships, self-efficacy theory, as incorporated into the Health Belief Model (HBM), was used as the study's guiding framework. The study examined the extent that nurse practitioners' attitudes, beliefs, and demographic factors were related to and predicted their self-efficacy in obesity treatment. The relationship between perceived self-efficacy and rating of importance and performances of weight management tactics was also explored. A random sample of 500 nurse practitioners from the American Academy of Nurse Practitioners was surveyed regarding their attitudes and beliefs about obesity treatment of adult patients as well as their weight management tactics. Data were collected using two validated instruments previously used to measure attitudes toward obesity treatment and weight management tactics in physician samples. Self-efficacy was determined using a composite score from three items. Nurses with a positive orientation toward obesity treatment scored higher in perceived self-efficacy (r =0.212, p=0.000). Higher self-efficacy ratings were associated with higher ratings on importance and performance of weight management approaches (r =0.488, p=0.000) and advice strategies (r =0.253, p=0.000). Stepwise regression analysis revealed that two negative attitudes toward obese patients, failure to feel empathy and negative reaction to appearance, and two positive attitudes, necessary to educate obese patients and making accommodations for obese patients accounted for 11% of the variance. Logistic regression indicated that older age (>45years), suburban residence, specialty education in obesity, continuing education in obesity, and using clinical guidelines to treat obesity were most predictive of self-efficacy in obesity treatment.