Effect of a diet, physical activity and weight counseling web course on physician reports and clinical behaviors

Individual counseling by clinicians may be an effective component to prevention and treatment of obesity. This study reports the effect of a web course intervention targeting primary care physicians recruited by each of four centers across the US (n=57). Each physician was randomly assigned to receive a course on assessment and counseling of diet, physical activity (PA) and weight status (n=35), or a comparison course on assessment and triage of skin lesions (n= 22). The intervention lessons reviewed background on obesity, the physician's role in addressing weight, and common physician counseling barriers (e.g., time, reimbursement, training), and strategies for quick and effective counseling practices. Measures included physician surveys, patient telephone calls, and chart abstraction performed by the research staff. Physicians exposed to the weight web course reported higher intention to discuss diet, activity and weight topics with patients compared with physicians exposed to the skin course (p<.05 for all three). No differences were found between groups in physician behaviors, confidence, attitudes, or office systems. At 12 months follow-up, a higher proportion of patients from diet course exposed physicians, compared to the skin course, reported their physicians talked about their diet, asked about PA, told them to improve their diet, how to eat healthier, increase fruits and vegetables, to increase PA, and appropriate PA(p<.05 for all). The differences were accentuated among higher weight patients. No differences in charting were between the two experimental groups. The web course was an effective channel to change counseling about diet, activity and weight among physicians.