Initiating weight discussions in primary care
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- Author(s)
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Alexander Redmann, DNP-FNP student; Rachael Urbaniak, DNP-FNP student; Jessica Neuman, DNP-FNP student
- Sigma Affiliation
- Non-member
Background: Research shows that many providers feel uncomfortable initiating weight discussions related to fear of sounding judgemental and inexperience in weight counseling. This leads to the failure of healthcare providers to intervene before weight issues become a greater diagnosis. The primary objective for this project is to determine if a screening tool aids providers in initiating weight discussions with patients.
Synthesis and Analysis of Supporting Literature: The evidence-based suggested solution is the utilization of a screening tool, based on the success of other screening tools such as the mental health PHQ-9. The screening tool of this project was developed by the project team; prioritizing two questions that would notify a provider if a patient is comfortable with or needs to discuss weight in their appointment. Lewin’s change theory guided the basis for this project; changing patterns and creating new ones that become the norm in clinical practice.
Project Implementation: Pre-implementation surveys were completed by eight participating providers to assess current comfortability and barriers in discussing weight. Implementation then began at three different clinics for a duration of three months. This included offering a pre-visit screening tool that asked if the patient was comfortable in discussing weight and if they were happy with their weight. The completed screening tools were given to participating providers. The goal was that this screening tool would aid providers in initiating a non-judgemental weight discussion. Providers were given a post-implementation survey to assess the effect of the screening tool on their comfortability and barriers of weight discussions.
Evaluation Criteria: Criteria evaluated included the pre and post-implementation provider surveys. Responses were reviewed and any changes in provider comfortability helped to
determine the overall effectiveness and outcome of the pre-visit screening tool. Additional supplemental criteria that was evaluated included optional patient surveys that inquired if a
weight discussion was had during their appointment, and if they saw any benefit to the pre-visit screening tool relating to any weight discussions.
Outcomes: Positive results were concluded as providers viewed the screening tool as an effective tool to initiate weight discussions and experienced less concern they would harm the
patient-provider relationship while utilizing the screening tool. Patients who participated in the optional patient-survey data revealed that 100% of patient respondents discussed weight in their visit that day.
Recommendations: More research in a larger sample size in a variety of primary care settings is needed to confirm the correlation between a screening tool and increased provider comfortability in initiating weight discussions.
The authors have presented a poster on this topic: http://hdl.handle.net/10755/22895
| Type | DNP Capstone Project |
| Acquisition | Self-submission |
| Review Type | None: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Quality Improvement |
| Research Approach | Qualitative Research |
| Keywords | Weight Related Conversations; Initiating Weight Discussions; Weight; Weight Discussion Tool; PHQ-9 |
| Grantor | The College of St. Scholastica |
| Advisor | Johnson, Sherry |
| Level | DNP |
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