Increasing general practitioners' confidence and self-efficacy in managing obesity: a mixed methods study

Abstract

ObjectivesInternationally, general practitioners (GPs) are being encouraged to take an active role in the care of their patients with obesity, but as yet there are few tools for them to implement within their clinics. This study assessed the self-efficacy and confidence of GPs before and after implementing a weight management programme in their practice.DesignNested mixed methods study within a 6-month feasibility trial.Setting4 urban general practices and 1 rural general practice in Australia.ParticipantsAll vocationally registered GPs in the local region were eligible and invited to participate; 12 GPs were recruited and 11 completed the study.InterventionsThe Change Programme is a structured GP-delivered weight management programme that uses the therapeutic relationship between the patient and their GP to provide holistic and person-centred care. It is an evidence-based programme founded on Australian guidelines for the management of obesity in primary care.Primary outcome measuresSelf-efficacy and confidence of the GPs when managing obesity was measured using a quantitative survey consisting of Likert scales in conjunction with pro forma interviews.ResultsIn line with social cognitive theory, GPs who experienced performance mastery during the pilot intervention had an increase in their confidence and self-efficacy. In particular, confidence in assisting and arranging care for patients was improved as demonstrated in the survey and supported by the qualitative data. Most importantly from the qualitative data, GPs described changing their usual practice and felt more confident to discuss obesity with all of their patients.ConclusionsA structured management tool for obesity care in general practice can improve GP confidence and self-efficacy in managing obesity. Enhancing GP ‘professional self-efficacy’ is the first step to improving obesity management within general practice.Trial registration numberACTRN12614001192673; Results.

What works and why in the identification and referral of adults with comorbid obesity in primary care: A realist review

“…As shown in Table S3, seven studies did not report any patient characteristics . Four studies reported on age and gender but did not provide any information on socio‐economic status (SES) or ethnicity .…”

“…There were a range of outcomes measured in the 30 studies, although most included at least one of the key outcomes of interest to this review, namely: Discussion of weight (including lifestyle advice); Measuring and recording of weight and/or BMI; and Referral to WMS …”

“…Several studies used other intervention strategies over and above the five already outlined. Patient education/information materials were common, including body mass index brochures, patient action plan template, food/activity logs, portion control plates/handouts, home exercise routines, calorie counters, community resource brochures, and food and fat models …”

“…Including desk‐based prompts such as flip‐charts and BMI charts in consulting rooms; BMI chart and stamp in notes , posters on walls, and written handbook…”

“…[27][28][29][30][31][32] As shown in Table S3, seven studies did not report any patient characteristics. 29,[33][34][35][36][37][38] Four studies reported on age and gender but did not provide any information on socio-economic status (SES) or ethnicity. [39][40][41][42] The remaining studies were more likely to include ethnicity data than data on SES; when reported, studies used a proxy of individual SES such as education or insurance status, rather than a multidimensional marker of SES such as the Index of Multiple Deprivation (IMD).…”