Managing health literacy for weight loss in primary health care

Mark Harris, Nighat Faruqi, Nigel Stocks, Oshana Hermiz, Kathryn Powell, Catherine Spooner, Nouhad El-Haddad
Publication type: 
Conference presentation
Stream 2 Disadvantaged populations
2015 PHC Research Conference, Adelaide, 29-31 July 2015.
For the presentation slides, click here.


Patient health literacy is a barrier to management of obesity.  In the PEP study of 30 practices from 4 states patients overweight patients were more likely to have low health literacy.  Qualitative feedback from GPs (referral study)

Aims and rationale

To evaluate the reported assessment and management of patients with obesity and low health literacy in their practice by general practitioners (GPs) and practice nurses (PNs).


Twenty practices in socioeconomically deprived areas were recruited to participate in a trial, 10 each in Sydney and Adelaide. GPs and PNs were invited to complete a validated self-completed questionnaire used in our previous research on their assessment and management of obese patients and attitudes to health literacy.


1.There were 61 participants: 37 GPs and 24 PNs. Characteristics

2.5As: More than half reported often assessing diet, physical activity and Body Mass Index (BMI) but only a quarter reported doing so for waist circumference. Most reported often advising patients to eat less fat and do regular exercise, especially GPs. Goal setting and referral was less frequently reported. GPs were more confident about these activities than PNs. 

2. Health literacy: Both reported infrequently assessing patients’ level of health literacy, asking patients to repeat key points or assisting them to access programs. 

3. Barriers: They most frequently reported lack of patient interest, and lack of time as barriers. Their attitudes were mostly positive towards treatment of obesity. However only 15% reported being successful with 26% enjoying the challenge of helping obese patients to manage their weight.


Interventions to improve assessment, education and referral of patients with low health literacy need to address negative previous experience with weight loss and low use of techniques to enhance communication and enhance referral navigation.