Cited by 158Obesity and Health PracticesPatient-Provider Communication in HealthcareObesity, Physical Activity, Diet

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Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

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Jay, Melanie, Gillespie, Colleen, Schlair, Sheira, Sherman, Scott, Kalet, Adina·2010·BMC Health Services Research

DOI 10.1186/1472-6963-10-159PMC PMC2903583

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Abstract

BACKGROUND: Physicians are encouraged to counsel obese patients to lose weight, but studies measuring the quality of physicians' counseling are rare. We sought to describe the quality of physicians' obesity counseling and to determine associations between the quality of counseling and obese patients' motivation and intentions to lose weight, key predictors of behavior change. METHODS: We conducted post-visit surveys with obese patients to assess physician's use of 5As counseling techniques and the overall patient-centeredness of the physician.. Patients also reported on their motivation to lose weight and their intentions to eat healthier and exercise. One-way ANOVAs were used to describe mean differences in number of counseling practices across levels of self-rated intention and motivation. Logistic regression analyses were conducted to assess associations between number of 5As counseling practices used and patient intention and motivation. RESULTS: 137 patients of 23 physicians were included in the analysis. While 85% of the patients were counseled about obesity, physicians used only a mean of 5.3 (SD = 4.6) of 18 possible 5As counseling practices. Patients with higher levels of motivation and intentions reported receiving more 5As counseling techniques than those with lower levels. Each additional counseling practice was associated with higher odds of being motivated to lose weight (OR 1.31, CI 1.11-1.55), intending to eat better (OR 1.23, CI 1.06-1.44), and intending to exercise regularly (OR 1.14, CI 1.00-1.31). Patient centeredness of the physician was also positively associated with intentions to eat better (OR 2.96, CI 1.03-8.47) and exercise (OR 26.07, CI 3.70-83.93). CONCLUSIONS: Quality of physician counseling (as measured using the 5As counseling framework and patient-centeredness scales) was associated with motivation to lose weight and intentions to change behavior. Future studies should determine whether higher quality obesity counseling leads to improved behavioral and weight outcomes.

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Authors: Jay, M., Gillespie, C., Schlair, S., Sherman, S., & Kalet, A.
Affiliations: New York University (US)
Montefiore Medical Center (US)
VA NY Harbor Healthcare System (US)
Corresponding author: Jay, Melanie
ORCID: Jay, Melanie
Gillespie, Colleen
Schlair, Sheira
Sherman, Scott
Kalet, Adina
Venue: BMC Health Services Research
Publisher: Springer Science and Business Media LLC
Published: 2010-06-09
Volume: 10
Issue: 1
Pages: 159-159
ISSN: 1472-6963 (ISSN-L)
DOI: 10.1186/1472-6963-10-159
PMC: PMC2903583
OpenAlex: W2007650959
Cited by: 158
References: 48
Citations by year: 2026: 5 · 2025: 5 · 2024: 9 · 2023: 4 · 2022: 7 · 2021: 9 · 2020: 8 · 2019: 10 · 2018: 11 · 2017: 11 · 2016: 13 · 2015: 19 · 2014: 15 · 2013: 15 · 2012: 11
FWCI: 23.56
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/2.0 (tdm)
Locations: BMC Health Services Research (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Centers for Disease Control and Prevention (CD000146-03)
Health Resources and Services Administration
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: obesity counseling, patient-centeredness, weight loss motivation, weight loss intentions, healthy eating intentions, exercise intention, behavior change, physician-patient communication
MeSH terms: Adult, Counseling, Female, Humans, Interviews as Topic, Male, Middle Aged, Models, Theoretical, Motivation, New York City, Obesity, Patients, Physician-Patient Relations, Weight Loss, Health Care Surveys, Intention, Risk Reduction Behavior

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Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

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