Patient Perspectives and Doctor Visits
Condition: Body Weight
MeSH terms: Body Weight
Study type: Observational

Summary: 
      Background:

      - We are studying people s psychological experiences and how these relate to the way people
      respond have when they see information communicated in different ways. We are testing
      multiple research questions in this research.

      Objectives:

      - To learn about how to design future research studies. Also to learn about how to best give
      people information about health topics.

      Eligibility:

      - Women with a Body Mass Index of 25 or higher.

      Design:

        -  Before the study visit, participants will answer some questions online about themselves,
           their experiences, and their thoughts about their weight.

        -  During the study visit, participants will watch a short scene from a movie, and then
           answer questions about it.

        -  Participants will have a simulated doctor visit with a computerized, virtual reality
           doctor. They will answer more questions about themselves, their experiences, and their
           thoughts about their weight. Then they will answer questions with researchers.
    

Detailed description: 
      The primary goal of this research project is to continue building an evidence base on the
      benefits or pitfalls of introducing genomic information into weight-related primary care
      encounters. We are particularly interested in how this information will impact patients
      health-related attitudes, beliefs and behavior, and patient perceptions of stigmatization.
      Furthermore, this project aims to determine whether a patient s emotional state during a
      clinical interaction will moderate the consequences of genomic information provision.

      Genetic and genomic information are expected to be integrated into personalized prevention
      and treatment regimens of the future. Such information may influence patient beliefs,
      attitudes, and behaviors related to weight and obesity. Previous research has shown that
      provision of genomic information can lead to positive effects, negative effects and often no
      effect with respect to patient motivation for health-promoting behaviors. The literature
      describing the influence of emotion on judgment and decision-making suggests that patients
      emotional state may, in part, account for this discrepancy. By better understanding the
      influence of emotional state on patients reactions to general, weight-related genomic
      information, we may be better able to shape clinical communications of the future to increase
      the likelihood that genomic information will lead to positive, health-promoting behavior.
      Indeed, there is a need for exploration of strategies through which providers can counsel
      patients about weight such that patients feel motivated by the counseling, and that it does
      not make them feel stigmatized.

      The current protocol describes two studies; both are randomized, controlled experiments. The
      first will be conducted through an internet panel via the Time-Sharing Experiments in the
      Social Sciences program. The current proposal was already reviewed and was successfully
      approved and funded for fielding through this program. The second study is a lab-based study
      that will take place in the Immersive Virtual Environment Testing Area in the NIH Clinical
      Center. In both studies, overweight, adult women will undergo a task designed to elicit
      mild-to-moderate emotional states. In Study 1 the elicited emotions will include anger, fear
      and neutral; Study 2 will include only anger and fear. Participants will then participate in
      a weight counseling encounter with a simulated doctor who will provide weight management
      information that includes discussions of either behavioral or genomic etiology. Participants
      in Study 1 will engage with the doctor via video clips over the internet, participants in
      Study 2 will engage with the doctor in an immersive virtual environment. Primary outcome
      measures pertain to participants health-related attitudes, behavioral intentions, and
      perceptions of stigmatization related to weight. Participants will include women who have a
      BMI of greater than or equal to 25. The final data set in Study 1 will include approximately
      600 participants who are already part of an existing, nationally representative internet
      panel (ceiling n=700). The final data set in Study 2 will include approximately 250
      participants recruited from the local area (ceiling n=500).
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        All participants will be adult women. Inclusion for Study 1 are: (1) being part of a
        Knowledge Networks Panel; (2) having a self-reported body mass index of greater than or
        equal to 25. Inclusion criteria for Study 2 are: (1) being between 18 and 50 years old; (2)
        having a self-reported body mass index of greater than or equal to 25; (3) having the
        ability to read, write, and converse in English; (4) being able to come to the NIH Clinical
        Center for one visit.
      
Keywords: Body Weight; Virtual Environment; Natural History