Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight

Katie O. Washington Cole, Kimberly A. Gudzune, Sara N. Bleich, Lawrence J. Cheskin, Wendy L. Bennett, Lisa A. Cooper, Debra L. Roter

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To examine the association of women's body weight with provider communication during prenatal care. Methods We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Results Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44–0.99, p = 0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32–0.82, p = 0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51–0.91, p = 0.01) and concern statements (IRR 0.68, 95% CI 0.53–0.86, p = 0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19–0.84 p = 0.02). Conclusion Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Practice implications Interventions to increase use of patient-centered communication – especially for women with overweight and obesity – may improve prenatal care quality.

Original languageEnglish (US)
Pages (from-to)1103-1110
Number of pages8
JournalPatient Education and Counseling
Volume100
Issue number6
DOIs
StatePublished - Jun 2017

Keywords

  • Interaction analysis
  • Obesity
  • Patient-provider communication
  • Pregnancy
  • Weight bias

ASJC Scopus subject areas

  • Medicine(all)

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