The Use of Motivational Interviewing to Increase Provider Confidence and Comfort in Addressing Obesity

Abstract

Purpose: The purpose of my project is to identify health care providers’ confidence and attitudes in addressing obesity and determine if asynchronous provider education including motivational interviewing (MI) is an effective tool in increasing providers’ confidence and attitude in addressing adult obesity in two primary care clinics in San Diego. Background: Obesity is associated with a significant risk for morbidity, mortality, and decreased quality of life. Current guidelines recommend primary care providers screen all adults for obesity and offer or refer obese patients to intensive counseling and multicomponent behavioral interventions. Despite clinical guidelines the crucial role of primary care providers in addressing rising trends in obesity, many providers fail to consistently adhere to obesity screening and management. MI a communication approach that may help providers overcome perceived barriers to addressing obesity with adult patients in the clinical setting. Methods: A 15-minute Likert scale pretest survey was electronically emailed to six providers in a primary care clinic. Details of the survey included: 1) Knowledge of MI and obesity management; 2) Attitudes associated with obesity; and 3) Perceived barriers to addressing obesity. All provider participants received an educational asynchronous PowerPoint focused on the use of MI to initiate obesity counseling and management. Following content viewing, provider participants were instructed to respond to a post-test survey identical to the pretest survey. Outcomes Achieved: Five primary care providers completed the pretest and posttest for a response rate of 75%. Participants include three nurse practitioners and two physicians. Overall and individual response scores improved in MI and obesity management knowledge. Overall attitudes towards obesity also showed improvement, however, individual attitude scores were inconsistent with responses ranging from improvement to unchanged or regressed. Consistent with findings from the literature common reported perceived barriers included time constraint, lack of patient adherence to obesity management, and lack of patient interest in receiving obesity counseling. Results were shared with participants and clinic management in the form of an executive summary of overall scores to protect identities of this small sample Conclusion: Asynchronous educational sessions focused on MI and obesity management are effective in addressing provider knowledge deficits. Future educational interventions should be modified to further address negative attitudes and perceived barriers in an effort to increase providers’ adherence to obesity screening and management guidelines. Following intervention improvements, this project will be reimplemented with a larger sample of primary care providers. Future research should include more extensive demographics and characteristics which may impact provider knowledge and attitude regarding obesity and addressing obesity with patients.