Effects of counseling techniques on patients’ weight-related attitudes and behaviors in a primary care clinic
Open accessAbstract
Objective Examine primary care physicians' use of counseling techniques when treating overweight and obese patients and the association with mediators of behavior change as well as change in nutrition, exercise, and weight loss attempts.Methods We audio recorded office encounters between 40 physicians and 461 patients. Encounters were coded for physician use of selected counseling techniques using the Motivational Interviewing Treatment Integrity (MITI) scale. Patient motivation and confidence as well as Fat and Fiber Diet score (1-4), Framingham physical activity questionnaire (MET-minutes), and weight loss attempts (yes/no) were assessed by surveys. Generalized linear models were fit, including physician, patient, and visit level covariates.Results Patients whose physicians were rated higher in empathy improved their Fat and Fiber intake 0.18 units (95% CI 0, 0.4). When physicians used "MI consistent" techniques, patients reported higher confidence to improve nutrition (OR 2.57, 95% CI 1.2, 5.7).Conclusion When physicians used counseling techniques consistent with MI principles, some of their patients' weight-related attitudes and behaviors improved.Practice implications Physicians may not be able to employ formal MI during a clinic visit. However, use of counseling techniques consistent with MI principles, such as expression of empathy, may improve patients' weight-related attitudes and behaviors.
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Even without a formal motivational interview, providers' use of patient-centered communication strategies improves individuals' confidence and success in changing health behaviors.
“Even without a formal motivational interview, though, providers’ use of patient-centered communication strategies improves individuals’ confidence and success in changing health behaviors.26,41,51”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [51]
The latter, less frequently performed 3 A's have the greatest impact on healthful behavior change.
“and it is these latter, less frequently performed 3 A’s that have the greatest impact on healthful behavior change.22,47–51”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [51]
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- Authors
- Cox, M. E., Yancy, W. S., Coffman, C. J., Østbye, T., Tulsky, J. A., Alexander, S. C., Brouwer, R. J. N., Dolor, R. J., & Pollak, K. I.
- Affiliations
- Duke Medical Center (US)
- Corresponding author
- Cox, Mary E.
- ORCID
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 85
- Issue
- 3
- Pages
- 363-368
- ISSN
- 0738-3991 (ISSN-L)
- PMC
- PMC3368547
- OpenAlex
- W2054112196
- Cited by
- 74
- References
- 20
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 9 · 2015: 13 · 2014: 10 · 2013: 11 · 2012: 8
- FWCI
- 23.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (R01CA114392)
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- motivational interviewing, obesity, overweight, weight loss behavior, patient motivation, patient confidence, physical activity, physician empathy, primary care, behavior change
- MeSH terms
- Adult, Aged, Attitude of Health Personnel, Attitude to Health, Community Health Centers, Counseling, Empathy, Female, Humans, Interviews as Topic, Male, Middle Aged, Motivation, North Carolina, Patients, Physician-Patient Relations, Surveys and Questionnaires, Tape Recording, Weight Loss, Health Behavior, Exercise, Treatment Outcome, Patient-Centered Care, Health Care Surveys, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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