Prompting lifestyle interventions to promote weight loss is safe, effective and patient-centred: No

Ballantyne, Angela; Steers, Denise; Gray, Lesley

doi:10.1071/hc23163

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…The first moot is 'prompting lifestyle interventions to promote weight loss is safe, effective or patient-centred', With Lawrenson arguing Yes, 2 and Ballantyne, Steers and Gray No. 3 Continuing the theme on eating and nutrition, Babbott and colleagues examine adolescent eating patterns and body image, recommending targeting positive constructs such as body appreciation and intuitive eating may be useful in facilitating wellbeing, 4 and McKerchar and colleagues explore how patients determine what is normal and what is abnormal gut function, and how they might view the diagnosis of a 'functional disorder'. 5 In a secondary analysis of postpartum survey data, Tutty and colleagues have found low levels of pre-pregnancy folic acid use in Central and South Auckland, with 58% use in planned pregnancies and 21% in those unplanned.…”

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confidence: 99%

The new coalition government: a step forward for primary care funding?

Goodyear-Smith,

Stokes

2023

J. Prim. Health Care

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In our guest editorial this month, Peter Crampton looks at the health agreements announced by the new coalition government. 1 He commends their intention to implement the Sapere report on capitation funding, which recommends funding based upon age, sex, ethnicity, deprivation and morbidity, which correlate to health need, as well as considerable investment in the extended primary care team. Of course, the devil will be in the detail. The actual formula that will be used and the degree to which primary care will be adequately funded is yet to be determined.This issue we re-introduce an old favourite in the Journal of Primary Health Care -the Back to Back series, whereby two professionals present opposing views to a moot. This explores areas of uncertainty, where there is no one right answer, and helps stimulate debate. The first moot is 'prompting lifestyle interventions to promote weight loss is safe, effective or patient-centred', With Lawrenson arguing Yes, 2 and Ballantyne, Steers and Gray No. 3 Continuing the theme on eating and nutrition, Babbott and colleagues examine adolescent eating patterns and body image, recommending targeting positive constructs such as body appreciation and intuitive eating may be useful in facilitating wellbeing, 4 and McKerchar and colleagues explore how patients determine what is normal and what is abnormal gut function, and how they might view the diagnosis of a 'functional disorder'. 5 In a secondary analysis of postpartum survey data, Tutty and colleagues have found low levels of pre-pregnancy folic acid use in Central and South Auckland, with 58% use in planned pregnancies and 21% in those unplanned. 1 Māori women were much less likely to take folic acid supplementation (12%), as were those cared by a community midwife rather than an obstetrician.Solutions need to fit with specific contexts. A qualitative study by Cullen and colleagues looking at what influences quality improvement in rural, urban and Kaupapa Māori primary care settings found that while generally no formal methods were applied, teams drew on available knowledge, their networks, and resources to identify adaptable and suitable quality improvement interventions that addressed identified needs. 6 Another qualitative study by Higgs and colleagues explored Pacific seniors' learning about their health and wellbeing from a weekly gathering involving exercise, health information and cultural activities. 7 The role of allied health professionals was identified in providing a holistic approach aligned with the pan-Pacific Fonofale model of health.Menezes and Eggleton have conducted a literature review looking at key ethical issues experienced by rural general practitioners, and found that the majority arise from overlapping relationships. 8 In small communities, their patients will inevitably be people with whom they also have personal relationships. Professional guidelines developed by Medical Councils do not account for this reality, and rural practitioners should look to progress a specific rural ethics agenda. In a...

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confidence: 99%

The new coalition government: a step forward for primary care funding?

Goodyear-Smith,

Stokes

2023

J. Prim. Health Care

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“…Here, they are often encouraged to rapidly lose weight to be able to access these services (Ballantyne et al, 2023;Simpson, 2015). This creates another barrier to accessing healthcare, as research has shown that there are many health risks associated with weight loss and for many people, weight loss will not be achievable at all (Bombak et al, 2019;Wray & Deery, 2008).…”

Section: Fatphobia and Discrimination In Healthcarementioning

confidence: 99%

“…Extracted 30/11/2021). This is concerning, considering that according to the Ministry of Health two out of every three people in Aotearoa NZ, aged 15 and over, are considered to be overweight, as well as one in eight tamariki (Ballantyne et al, 2023;McCormack & Burrows, 2015). The significant underutilisation (and/or the failure to document and report on the use) of long needles in Aotearoa NZ is further evidence of the privileging of thinness and the subsequent disregard for larger bodies and their health/needs during the COVID-19 pandemic.…”

Section: Laying Inequities Bare: Covid-19 Vaccination Inequities For ...mentioning

confidence: 99%

Self-Identified Fat Peoples Experiences of COVID-19 Vaccination Centre's in Aotearoa NZ

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<p><strong>This study investigates self-identified fat people’s experiences of COVID-19 vaccination centres in Aotearoa NZ. This includes attention to multiple facets of the experience of COVID-19 vaccination centres including the physical environment, interaction with service providers, and knowledge of and access to a long needle in accordance with Ministry of Health vaccination guidelines. The thesis employs a critical realist/contextualist approach, underpinned by the theory of body privilege. Qualitative content analysis is used to analyse open-ended survey responses collected as part of a broader international study. Three main themes are identified from the data set. The first theme, ‘“Crammed in Like Sardines”: Navigating COVID-19 vaccination centre environments’ found mixed experiences and a number of challenges in fat people’s access to and movement through vaccination centres. The second theme, “Thank fuck for fat activists”: The need for COVID-19 vaccination advocacy’ captured the importance that fat people’s advocacy played, both at the individual and community level in ensuring access to COVID-19 vaccinations and in raising awareness about long needle guidelines. The third theme, ‘“I worry about the effectiveness of my vaccine now”: Trust and authority in the vaccination encounter’ identifies the power imbalance within vaccination centres that placed authority with the vaccinator and undermined fat people’s self-advocacy and self-determination for long needle use. I demonstrate the corrosive impact this had on fat people’s confidence that they were protected from COVID-19 and subsequently their trust in the governments COVID-19 responsiveness for fat people. Findings highlight the healthcare inequities experienced by fat people when accessing COVID-19 vaccination that can also be seen reflected in everyday healthcare systems and settings. Vaccination centers were found to privilege thinness at both a structural and interactional level which excluded fat people and disregarded the needs of the fat community as well as other marginalized communities. These inequities ultimately served to undermine public health policies that were meant to protect and provide equitable care to the entire population. The neglect of fat people’s needs led to the requirement of advocacy by fat people to seek accessible and equitable healthcare. Whilst effective in helping promote protection for fat people, public health programmes that rely on community and self-advocacy to ensure responsiveness to marginalized communities is neither a fair solution nor is it sustainable in the long term. Research findings point to important lessons to be learned to ensure the inclusion of and responsiveness to fat people in future pandemic responses and in healthcare systems more generally.</strong></p>

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Prompting lifestyle interventions to promote weight loss is safe, effective and patient-centred: No

Cited by 2 publications

References 30 publications

The new coalition government: a step forward for primary care funding?

The new coalition government: a step forward for primary care funding?

Self-Identified Fat Peoples Experiences of COVID-19 Vaccination Centre's in Aotearoa NZ

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