Using conversation analysis to review and improve brief weight loss interventions in primary care

Albury, CVA

Abstract:: National guidelines exhort GPs to give brief opportunistic interventions for weight loss which incorporate the offer of referral to an effective behavioural programme, such as a commercial weight management service (CWMS). These brief interventions have been shown to be effective. However, GPs rarely deliver these interventions, and have requested more support to facilitate delivery. Current guidelines provide little detail to support GPs because there is sparse evidence regarding how to d...
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APA Style

Albury, C. V. A. (2019). Using conversation analysis to review and improve brief weight loss interventions in primary care [PhD thesis]. University of Oxford.

MLA Style

Albury, CVA. Using Conversation Analysis to Review and Improve Brief Weight Loss Interventions in Primary Care. 2019. University of Oxford, PhD thesis.

Chicago Style

Albury, CVA. 2019. “Using Conversation Analysis to Review and Improve Brief Weight Loss Interventions in Primary Care.” PhD thesis, University of Oxford.
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Files:: Albury_2019_Using_conversation_analysis.pdf

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Authors

+ Albury, CVA More by this author

Division:: MSD
Department:: Primary Care Health Sciences
Role:: Author

Contributors

+ Aveyard, P

Role:: Supervisor

+ Ziebland, S

Role:: Supervisor

+ Stokoe, L

Role:: Supervisor

+ Webb, H

Role:: Supervisor

+ National Institute for Health Research More from this funder

Grant:: School for Primary Care Research (NIHR SPCR)

DOI:: 10.5287/ora-7jygqvwwb
Type of award:: DPhil
Level of award:: Doctoral
Awarding institution:: University of Oxford

Language:: English
Keywords:: health care

primary care

medical communication

health behaviours

behaviour change

conversation analysis

obesity
Subjects:: Health Behaviours

Primary care (Medicine)

Conversation Analysis
UUID:: uuid:8bd7e947-9d42-404d-8017-c659f1d4ff34
Deposit date:: 2020-02-05
ARK identifier:: ark:/29072/ora_8bd7e9479d42404d8017c659f1d4ff34

Related item:: Screening and brief intervention for obesity in primary care: a parallel, two-arm, randomised trial
Description:: Background Obesity is a common cause of non-communicable disease. Guidelines recommend that physicians screen and offer brief advice to motivate weight loss through referral to behavioural weight loss programmes. However, physicians rarely intervene and no trials have been done on the subject. We did this trial to establish whether physician brief intervention is acceptable and effective for reducing bodyweight in patients with obesity.MethodsIn this parallel, two-arm, randomised trial, patie...
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Related item:: GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care
Description:: Background Guidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.Aim To examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and setting A mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.Method Conversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.Results Affirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.Conclusion When doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.

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Licence:: Terms and Conditions of Use for Oxford University Research Archive

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Using conversation analysis to review and improve brief weight loss interventions in primary care

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Using conversation analysis to review and improve brief weight loss interventions in primary care

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