Variations between obese latinos and whites in weight-related counseling during preventive clinical visits in the United States

Authors

  • Jun Ma,

    Corresponding author
    1. Stanford Prevention Research Center, Stanford University, Stanford, California, USA
    • Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA
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  • Lan Xiao,

    1. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA
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  • Veronica Yank

    1. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA
    2. Stanford Prevention Research Center, Stanford University, Stanford, California, USA
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  • Funding agencies: This research was supported by internal funding from the Palo Alto Medical Foundation Research Institute. Disclosure The authors declared no conflict of interest.

    The funding source had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

Correspondence: Jun Ma (maj@pamfri.org)

Abstract

Objective

To examine rate differences and explanatory factors for lifestyle counseling to obese Latinos versus non-Hispanic whites (NHWs) in U.S. outpatient settings.

Design and Methods

The 2009 National Ambulatory Medical Care Survey data assessed the provision of weight-related lifestyle counseling during general medical exam visits (n = 688) by obese Latino and NHW adults. The Blinder-Oaxaca decomposition technique to identify the fraction of the overall ethnic difference in counseling rate explained by a selection of measured variables based on the Anderson-Newman-Aday behavioral model were used.

Results

Although weight-related lifestyle counseling rates were low in both ethnic groups, the rate among obese Latinos (51.3%) was significantly higher than among NHWs (35.8%) (P = 0.03), with 60% of the difference explained by observed factors. Enabling factors such as provider specialty, metropolitan statistical area, practice type, and provider employment type contributed the most to higher counseling rates among Latinos, whereas geographic region, continuity of care, and health insurance were enabling factors that, along with the predisposing factor of sex, contributed the most in the opposite direction.

Conclusions

Obese Latinos are more likely to receive weight-related counseling during general medical exams than do NHWs, which is partly explained by physician practice and patient factors.

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