Abstract A49: Shared decision-making about weight loss and weight maintenance among a diverse sample of obese primary care patients
Authors: Jefferson Melanie S. , Rice Lashanta , Chukwuka Kemi , Pierce Holly , Riley Jodie , Hughes-Halbert Chanita 
Published: March 2017

Abstract
Background: Obesity and excess body weight are significant clinical and public health issues that disproportionately affect racial and ethnic minorities. Weight control and management are essential to obesity prevention and reduction; racial and ethnic disparities in cancer outcomes are due in part to limited weight control/management through reduced physical activity and unhealthy dietary behaviors. Healthcare providers play an important role in helping patients perform these cancer control behaviors through effective patient-provider communication that facilitates shared decision making. However, limited empirical data are available on the extent to which shared decision making occurs among diverse patients in primary care settings within the context of cancer control behaviors.
Objective: The objective of this study was to evaluate perceptions of shared decision making about weight control and management in a racially and geographically diverse sample of primary care patients.
Methods: We conducted an observational survey study in a sample of 106 racially and ethnically diverse primary care patients from primary care practices located across the U.S. Shared-decision making (SDM) was measured by self-report using an adapted version of the Shared Decision-Making Scale that measured perceived SDM for weight control/management. Bivariate and multivariate regression analysis was used to identify sociodemographic, clinical, and psychological factors having significant independent associations with SDM.
Results: 42% of the sample were from racial/ethnic minority groups and 58% were white. In addition, the majority of participants were married (62%), had at least some college education (62%), were employed (55%), and received medical care in rural primary care practices (97%). With respect to clinical characteristics, 69% were obese, but only 55% believed they were obese or overweight. Scores for SDM ranged from 8 to 32 and the Mean (SD) was 17.1 (7.4); consistent with this, the majority of patients reported that providers were not likely to make clear that a decision needs to be made about their weight management, select a weight management option with their provider, or reach an agreement on how to proceed about their weight management. In the bivariate analyses, SDM scores where significantly higher among patients who had greater readiness to control/manage their weight (t=-2.47, p=0.02), who believed they were overweight/obese (t=-2.41, p=0.02), and were making weight loss efforts (t=-2.56, p=0.01) compared to those who were not making weight loss efforts, patients who did not believe they were obese/overweight, and those who were not ready to control/manage their weight. In the multivariate regression analysis, perceived obesity had a marginally significant positive association with SDM (p=0.08).
Conclusions: Patient perceptions of SDM was low in our sample. Greater efforts are needed to enhance SDM about weight management/control between patients and providers, particularly among those who do not believe they are overweight/obese.
Citation Format: Melanie S. Jefferson, Lashanta Rice, Kemi Chukwuka, Holly Pierce, Jodie Riley, Chanita Hughes-Halbert. Shared decision-making about weight loss and weight maintenance among a diverse sample of obese primary care patients. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A49.