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04-29-2017 | Obesity | Article

Impact of Physician Training on Diagnosis and Counseling of Overweight and Obese Asian Patients

Journal:
Journal of Racial and Ethnic Health Disparities

Authors: Deepa A. Vasudevan, Thomas F. Northrup, Sreedhar Mandayam, Oluwatosin O. Bamidele, Angela L. Stotts

Publisher: Springer International Publishing

Abstract

Obesity is widely underdiagnosed among Asians, due in part to a lack of physician awareness of the modified diagnostic criteria for Asians. This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients.
Physicians ( N = 16) from five primary care practices received 1 h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12 months before the training ( n = 198) and 3 months following the training ( n = 163). Physician race (Asian/non-Asian) and clinic setting (private/academic) were included as outcome moderators.
Patients were predominantly male (63.1 %), with a mean age of 46.0 years (SD = 14.9) and an average BMI of 28.2 (SD = 3.8). Across all physicians, 26.8 and 45.1 % of patients were accurately diagnosed as overweight or obese before and after the training, respectively ( p < 0.05). The odds of a physician correctly diagnosing Asian patients as overweight or obese were 102 % higher at post-training after accounting for nesting of patients within physicians. Similarly, weight counseling was higher (65.0 %) following training compared to pre-training levels (43.9 %) but failed to reach significance ( p = 0.06).
Accurate identification and counseling of overweight/obese Asian patients can be improved by education and training. Universal adoption of race-specific guidelines will ensure more successful weight management and reduced morbidity in a rapidly growing Asian population.

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