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 Bennett, Lisa A Cooper, Debra Roter

Research output: Contribution to journalArticle

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)
JournalPatient Education and Counseling
DOIs
StateAccepted/In press - Jul 7 2016

Fingerprint

Prenatal Care
Pregnant Women
Obesity
Communication
Body Weight
Life Style
Self Disclosure
Body Mass Index
insulin receptor-related receptor
Weights and Measures
Pregnancy

Keywords

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

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "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",
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.",
keywords = "Interaction analysis, Obesity, Patient-provider communication, Pregnancy, Weight bias",
author = "{Washington Cole}, {Katie O.} and Gudzune, {Kimberly A} and Bleich, {Sara N} and Cheskin, {Lawrence J} and Wendy Bennett and Cooper, {Lisa A} and Debra Roter",
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language = "English (US)",
journal = "Patient Education and Counseling",
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AU - Washington Cole, Katie O.

AU - Gudzune, Kimberly A

AU - Bleich, Sara N

AU - Cheskin, Lawrence J

AU - Bennett, Wendy

AU - Cooper, Lisa A

AU - Roter, Debra

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N2 - 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.

AB - 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.

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KW - Weight bias

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