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

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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).</p> <p>Conclusions</p> <p>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.</p

PREPARATION OF THE POLYMERIC COMPOSITES OF BASED ON CHITOSAN AND POLYVINYLPYRROLIDONE

The process of the preparing compositions based on chitosan and water-soluble monomer N-vinylpyrrolidone in the presence of ammonium persulfate polymerization initiator are deter-mined. The viscometric studies in the presence of chitosan solutions of ammonium persulfate are conducted. The optimum conditions for the synthesis of copolymers with chitosan and polyvinylpyrrolidone (temperature, pH, mixing ratio) are proposed

ОТРИМАННЯ ПОЛІМЕРНИХ КОМПОЗИТІВ НА ОСНОВІ ХІТОЗАНУ ТА ПОЛІВІНІЛПІРОЛІДОНУ

The process of the preparing compositions based on chitosan and water-soluble monomer N-vinylpyrrolidone in the presence of ammonium persulfate polymerization initiator are deter-mined. The viscometric studies in the presence of chitosan solutions of ammonium persulfate are conducted. The optimum conditions for the synthesis of copolymers with chitosan and polyvinylpyrrolidone (temperature, pH, mixing ratio) are proposed.Отримано композити на основі хітозану та водорозчинного мономеру N-вінілпіролідону в присутності ініціатора полімеризації – персульфату амонію. Проведено віскозиметричні дослідження розчинів хітозану в присутності ініціатору полімеризації. Підібрано оптимальні умови синтезу щеплених кополімерів хітозану з N-вінілпіролідоном (температура, рН, співвідношення компонентів)

Systematic Transcreation of Self-Help Smoking Cessation Materials for Hispanic/Latino Smokers: Improving Cultural Relevance and Acceptability

Smoking-related illnesses are the leading causes of death among Hispanics/Latinos. Yet, there are few smoking cessation interventions targeted for this population. The goal of this study was to “transcreate” an existing, previously validated, English language self-help smoking cessation intervention, titled Forever Free®: Stop Smoking for Good, for Spanish-speaking smokers. Rather than simply translating the materials, our transcreation process involved culturally adapting the intervention to enhance acceptability and receptivity of the information. We utilized a multiphase qualitative approach (focus groups and learner verification interviews) to develop a linguistically and culturally relevant intervention for the diverse sub-ethnic groups of Hispanic/Latino smokers. Focus group findings indicated a need to underscore several additional cultural characteristics and themes such as the need to address familism and unique stressors faced by immigrants and to provide information regarding nicotine replacement therapy. Learner verification findings indicated a need to further emphasize financial and social benefits of quitting smoking and to discuss how family and friends can support the quit attempt. These steps led to the development of a Spanish-language smoking cessation intervention titled, Libre del cigarillo, por mi familia y por mí: Guía para dejar de fumar, that is currently being tested in a national randomized controlled trial

Abstract A09: Transcreating self-help smoking cessation intervention materials for Hispanic/Latino smokers: Focus group and learner verification findings

Abstract There is a dearth of evidence-based smoking-cessation interventions for Hispanic/Latino smokers, especially for individuals with limited or no English proficiency. Hispanics/Latinos make up 17% of the national population, and in some Hispanic sub-ethnic groups, such as Puerto Ricans and Cubans, smoking prevalence rates are over 30% (greatly exceeding rates of non-Hispanic Whites at 18.1%). Thus, we sought to transcreate our existing validated English-language “Stop Smoking for Good” self-help smoking cessation intervention for Spanish-speaking smokers. The transcreation process involves a series of steps involving translating the text into another language, as well as infusing culturally relevant context, photos, and themes. To begin, focus groups were conducted to assess reactions to the existing English-language materials (10 booklets and 9 pamphlets), and to gather suggestions to adapt content for the intended audience. Specifically, we aimed to identify culturally relevant smoking cessation barriers as well as elements that would increase acceptability in this population. Focus group participants (N=23) were bilingual Hispanic/Latino smokers representing diverse sub-ethnic groups. A key theme that emerged was familism, defined by the sense of attachment, loyalty and collective well-being among the nuclear as well as extended family. This finding prompted us to develop an additional booklet aimed at providing family and friends with the tools necessary to support their loved one's quit attempt. Other findings included: religion and spirituality as a coping mechanism; the role of coffee as a trigger for smoking; and difficulties for immigrants that serve as stressors for smoking, such as language barriers, being separated from one's family, and financial problems. Format change suggestions were also reported by participants and included a desire for color images, preference for a bright color palette, and interactive activities. Focus group findings then informed the development of a Spanish-language version of the booklets entitled, “Libre del cigarrillo, por mi familia y por mí.” Subsequently, learner verification interviews (N=10) were conducted with Spanish-speaking Hispanic/Latino smokers who preferred their health education materials in Spanish to assess the appeal and acceptability of the revised content and visual modifications. Overall, participants responded favorably to the revised content. The learner verification process also revealed a need to: expand the explanation of quitting aids, include additional culturally salient daily stressors, and further emphasize the financial benefits of quitting smoking. We will present additional qualitative results from the focus groups and learner verification interviews as well as the finalized Spanish-language version of the booklets. The final version of the Spanish-language materials will be tested in a randomized controlled trial. Citation Format: Diana B. Díaz, Luis M. Monsalve, Thomas H. Brandon, Bárbara Piñeiro, Lauren R. Meltzer, Cathy D. Meade, Karen O. Brandon, Marina Unrod, Vani N. Simmons. Transcreating self-help smoking cessation intervention materials for Hispanic/Latino smokers: Focus group and learner verification findings. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A09.</jats:p