Godin, Steven W., PhD, MPH, PHI Certificate

Green-McKenzie, Judith, MD, MPH, FACOEM

Vrablik, Kevin A., MD, MPH, FACOEM

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineThe Relationship of Body Mass Index on PrimaryCare Physician Practice Behaviors with TheirOverweight and Obese PatientsKevin A. Vrablik MD, MPH, FACOEMLehigh Valley Health Network, kevin.vrablik@lvhn.orgJudith Green-McKenzie MD, MPH, FACOEMSteven W. Godin PhD, MPH, PHI CertificateFollow this and additional works at: https://scholarlyworks.lvhn.org/medicinePart of the Medical Sciences Commons, Medical Specialties Commons, and the OccupationalHealth and Industrial Hygiene CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtVrablik, K., Green-McKenzie, J., & Godin, S. (2014, April 27-30). The relationship of body mass Index on primary care physician practicebehaviors with their overweight and obese patients. Poster presented at: The 2014 American Occupational Health Conference, SanAntonio, TX.Objectives Methods Introduction Results (Continued) The Relationship of Body Mass Index on Primary Care Physician Practice Behaviors with their Overweight and Obese Patients Conclusions Kevin A. Vrablik, MD, PH Certificate, FACOEM Judith Green-McKenzie, MD, MPH, FACOEM      Occupational Medicine Residency Program Steven W. Godin, PhD, MPH, PHI Certificate      East Stroudsburg University, Department of Health Studies Results  The Centers for Disease Control and Prevention in 2010 reported that 69% of adults over 20 years of age were overweight or obese  The 2012 Medscape Physician Lifestyle Report found 42% of male physicians and 32% of female physicians were overweight or obese  A review of the literature by Reilly (2007) found numerous studies showing physicians are less effective at giving credible advice and health counseling when they have unhealthy lifestyle habits themselves  Bleich, et al, (2012) found normal BMI physicians provided recommended obesity care to their patients and felt confident doing so compared to overweight physicians This study investigates if there is a relationship between LVHN Primary Care Physicians’ BMI and their: 1) overweight and obese patient practice behaviors  2) self-perceptions about whether they are a good role model for  weight management of their overweight and obese patients 3) self-perceptions about whether overweight and obese patients have confidence in their weight management evaluation and treatment  This group of primary care physicians had higher obesity rates than US physicians  In this specific group of physicians, there were no significant differences found in physician practice behaviors based on their BMI class  There was a statistically significant difference between physician BMI class and self-perceptions of being a role model for their patients Limitations  Study used a volunteer sample, which can be affected by selection bias  Cross sectional study looks at associations, not causation  Physician height and weight were self-reported, which can lead to an underestimated BMI  The survey was not a validated instrument  Because this was an anonymous survey, there is no data on the physicians who did not participate  Small sample size at one healthcare system, probably not generalizable/externally valid  108 surveys were completed • 12 surveys had incomplete responses • 4 surveys consent was not provided • 1 survey was a duplicate  A total of 91 surveys were included in the analysis • Two height entries were corrected l l l l l  I am a role model for my patients when it comes to their weight management (F2,88=16.396, p<0.001) My patients have confidence in my ability to counsel them in weight loss management  My own weight plays a role in whether I counsel my patients about their weight  Study Design  Self-administered, local, anonymous cross-sectional  survey using “SurveyMonkey,” distributed by email   Participants  Inclusion criteria: 189 Lehigh Valley Health Network  Primary Care Physicians who completed the survey   in February to April 2013  Exclusion criteria: incomplete survey, missing  height and/or weight, consent not provided   Instrument  Self-designed, piloted, 21 question online  questionnaire capturing demographic information  and using a 5-point Likert-type scale and a 6-point  ordinal scale to assess physicians’ self-perceptions  and overweight/obese patient practice behaviors   Variables  Independent – Physician BMI class   Normal:   18 < 25 kg/m2   Overweight:  25 ≤ 30 kg/m2   Obese:        ≥ 30 kg/m2  Dependent – practice behaviors, self-perceptions   Statistical Analysis Descriptive statistics, student’s t-test and Analysis of  Variance with Tukey HSD and Duncan post hoc testing using SPSS was utilized to test for differences between gender, medical degree, BMI classes and physicians’ practice behaviors and self-perceptions  This study was approved by both the Lehigh Valley Health Network and the East Stroudsburg University Institutional Review Boards 1 = Strongly Disagree   2 = Disagree   3 = Neutral   4 = Agree   5 = Strongly Agree   There were no statistically significant differences in physicians’ practice behaviors with overweight/obese patients based on BMI   Female physicians were statistically more likely to refer to bariatric medicine and MD’s were more likely to write an exercise prescription   The only statistical difference based on BMI class was the physicians’ self-perception of being a role model regarding weight management to their overweight/obese patients   1  Normal    Normal   Obese    Normal    Overweight    Obese    Obese    Overweight    Overweight  2 3  4 5                    5-point Likert-type Scale The author would like to acknowledge Lynne Taylor, PhD for her assistance with graphing using SAS. This research was supported in part by training grants from the National Institute of Occupational Safety and Health - grant number: 5-TO1-0H008628, and the Health Resources and Services Administration - grant number: D33HP25770-01-00 n % n %Medical Degree Type     M.D. 35 64% 20 36%     D.O. 18 50% 18 50%Practice Type     Family Medicine 29 54% 25 46%     Internal Medicine 22 71% 9 29%     Other 2 33% 4 67%BMI Class     Normal 20 38% 23 60%     Overweight 26 49% 9 24%     Obese 7 13% 6 16%PHYSICIAN DEMOGRAPHICSMALE FEMALE

The Relationship of Body Mass Index on Primary Care Physician Practice  Behaviors with Their Overweight and Obese Patients

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The Relationship of Body Mass Index on Primary Care Physician Practice Behaviors with Their Overweight and Obese Patients

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