Primary Care Physicians’ Experiences of Obesity Counseling and Management in Culturally and Linguistically Diverse Populations.

Abstract

Abstract -Objective: The purpose of the study was to explore Primary care physicians’ experiences and perspectives of obesity counseling and management of culturally and linguistically diverse populations (CALD). Particularly in reference to Spanish speaking patients with low English proficiency (LEP). -Methods: Semi-structured interviews were employed to achieve the aim of this study. 27 interviews were conducted. Participants were recruited from medical practices in Bernalillo county, New Mexico and Monmouth county, New Jersey. All participants provided primary care in clinics with a large proportion of LEP individuals. Of the 27 physicians, 17 were males and 10 were females. 23 physicians were trained in Internal Medicine and 4 were trained in Family medicine. All providers were either American board certified or board eligible. All interviews were conducted in English while encounters were audio taped. All transcripts were de-identified, followed by inductive thematic analysis. -Results: On average, interviews lasted 14 minutes. Thematic analysis of the interview transcripts identified 5 key themes: time constraints, chief complaint prioritization, lack of knowledge on access pathways, limited health literacy, and physician bias. -Conclusion: Physicians perceived obesity counseling and management in culturally and linguistically diverse patients to be more challenging. Barriers identified included time constraints, chief complaint prioritization and physician bias. Cultural competence training for healthcare professionals, setting up follow-up appointments specifically to initiate obesity counseling, or considering referrals to a dedicated obesity clinic to primarily manage obesity may address the management gaps of for obesity in CALD patients. In addition, physicians’ education on billing and insurance reimbursement related to obesity can help providers better navigate counseling and management of this population.