Obesity management in middle age adults with low health literacy in general practice: The Better Weight Management in General Practice Trial

Author: 
Mark Harris, Nighat Faruqi, Nigel Stocks, Oshana Hermiz, Catherine Spooner, Nouhad El-Haddad
Publication type: 
Conference presentation
Program: 
Stream 2 Disadvantaged populations
Year: 
2015

Australian and New Zealand Obesity Society (ANZOS) Annual Scientific Meeting, Melbourne, 16-18 October 2015

PDF of the poster is available here.

Introduction

Lack of health literacy has been identified as a key barrier to weight management.  One in five Australians have very low health literacy and those with low health literacy are more likely to be physical inactive and overweight or obese.  Patients with low health literacy are often mistakenly perceived as being less motivated and engaged in their care. This presentation describes the method and early findings from of the BMWGP trial which aims to evaluate an intervention to address health literacy for weight management of obese patients in general practice.

Methods

Twenty practices in socioeconomically deprived areas (10 each in Sydney and Adelaide) were recruited to participate and randomized to intervention or control groups.  The intervention includes clinical audit, training and facilitation of practice nurses (PN) role in the management of obesity and in the assessment of health literacy, communication techniques and goal setting, referral navigation to weight management education and coaching and follow up.    Outcome measures include quality of care, diet and physical activity behaviors, BMI, waist circumference, health literacy and quality of life.

Results

At baseline more than half of GPs and PNs reported often assessing diet, physical activity and Body Mass Index (BMI) but only a quarter reported doing so for waist circumference.  This was in accordance with the findings from medical record audit.  Goal setting and referral was less frequently reported by providers and patients. Assessment of patients’ level of health literacy, and use of techniques for communication and referral navigation were infrequent.  GPs and PNs in the intervention group actively engaged with the health literacy intervention.  

Conclusion

The management of weight in patients with obesity and low health literacy presents a particular challenge in general practice.  Specific strategies to deal with this are currently infrequently used but are feasible to deploy.