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Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice

BACKGROUND: GPs are encouraged to make brief interventions to support weight loss, but they report concern about these conversations, stating that they need more details on what to say. Knowing how engage in these conversations could encourage GPs to deliver brief interventions for weight loss more...

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Autores principales: Albury, Charlotte V A, Ziebland, Sue, Webb, Helena, Stokoe, Elizabeth, Aveyard, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211147/
https://www.ncbi.nlm.nih.gov/pubmed/33340401
http://dx.doi.org/10.1093/fampra/cmaa121
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author Albury, Charlotte V A
Ziebland, Sue
Webb, Helena
Stokoe, Elizabeth
Aveyard, Paul
author_facet Albury, Charlotte V A
Ziebland, Sue
Webb, Helena
Stokoe, Elizabeth
Aveyard, Paul
author_sort Albury, Charlotte V A
collection PubMed
description BACKGROUND: GPs are encouraged to make brief interventions to support weight loss, but they report concern about these conversations, stating that they need more details on what to say. Knowing how engage in these conversations could encourage GPs to deliver brief interventions for weight loss more frequently. OBJECTIVE: To examine which specific words and phrases were successful in achieving conversational alignment and minimizing misunderstanding, contributing to effective interventions. METHODS: A conversation analysis of English family practice patients participating in a trial of opportunistic weight-management interventions, which incorporated the offer of referral to community weight-management services (CWMS). Qualitative conversation analysis was applied to 246 consultation recordings to identify communication patterns, which contributed to clear, efficient interventions. RESULTS: Analysis showed variation in how GPs delivered interventions. Some ways of talking created misunderstandings or misalignment, while others avoided these. There were five components of clear and efficient opportunistic weight-management referrals. These were (i) exemplifying CWMS with a recognizable brand name (ii) saying weight-management ‘programme’ or ‘service’, rather than ‘group’ or ‘club’ (iii) stating that the referral is ‘free’ early on (iv) saying the number CWMS visits available on referral (v) stating that the CWMS programme available was ‘local’. CONCLUSIONS: When making a brief opportunistic intervention to support weight loss, clinicians can follow these five steps to create a smooth and efficient intervention. Knowing this may allay clinicians’ fears about these consultations being awkward and improve adherence to guidelines.
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spelling pubmed-82111472021-06-21 Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice Albury, Charlotte V A Ziebland, Sue Webb, Helena Stokoe, Elizabeth Aveyard, Paul Fam Pract Qualitative Research BACKGROUND: GPs are encouraged to make brief interventions to support weight loss, but they report concern about these conversations, stating that they need more details on what to say. Knowing how engage in these conversations could encourage GPs to deliver brief interventions for weight loss more frequently. OBJECTIVE: To examine which specific words and phrases were successful in achieving conversational alignment and minimizing misunderstanding, contributing to effective interventions. METHODS: A conversation analysis of English family practice patients participating in a trial of opportunistic weight-management interventions, which incorporated the offer of referral to community weight-management services (CWMS). Qualitative conversation analysis was applied to 246 consultation recordings to identify communication patterns, which contributed to clear, efficient interventions. RESULTS: Analysis showed variation in how GPs delivered interventions. Some ways of talking created misunderstandings or misalignment, while others avoided these. There were five components of clear and efficient opportunistic weight-management referrals. These were (i) exemplifying CWMS with a recognizable brand name (ii) saying weight-management ‘programme’ or ‘service’, rather than ‘group’ or ‘club’ (iii) stating that the referral is ‘free’ early on (iv) saying the number CWMS visits available on referral (v) stating that the CWMS programme available was ‘local’. CONCLUSIONS: When making a brief opportunistic intervention to support weight loss, clinicians can follow these five steps to create a smooth and efficient intervention. Knowing this may allay clinicians’ fears about these consultations being awkward and improve adherence to guidelines. Oxford University Press 2020-12-19 /pmc/articles/PMC8211147/ /pubmed/33340401 http://dx.doi.org/10.1093/fampra/cmaa121 Text en © The Author(s) 2020. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Qualitative Research
Albury, Charlotte V A
Ziebland, Sue
Webb, Helena
Stokoe, Elizabeth
Aveyard, Paul
Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice
title Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice
title_full Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice
title_fullStr Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice
title_full_unstemmed Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice
title_short Discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in UK family practice
title_sort discussing weight loss opportunistically and effectively in family practice: a qualitative study of clinical interactions using conversation analysis in uk family practice
topic Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211147/
https://www.ncbi.nlm.nih.gov/pubmed/33340401
http://dx.doi.org/10.1093/fampra/cmaa121
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