General practitioner views on addressing weight opportunistically in primary care: An embedded sequential mixed-methods study

Abstract

Objective: To assess GPs' thoughts, feelings, and practices on providing opportunistic weight loss interventions before and after educational training and application in practice.

Methods: In an embedded sequential mixed-methods design, 137 GPs delivered a 30-second brief opportunistic intervention to a mean of 14 patients with obesity. To assess GPs' experiences and views on the intervention, all were invited to complete pre- and post-trial questionnaires and 18 were purposively interviewed. Data were transcribed verbatim and analysed using inductive framework analysis.

Results: GPs' attitudes (importance, feasibility, appropriateness, helpfulness, and effectiveness), capacities (comfort, confidence, and knowledge), perceived subjective norms (role expectations), willingness, and intentions on providing weight loss interventions were predominantly improved post-trial. The research setting allowed GPs to depersonalise intervening on obesity and feel more comfortable discussing the topic. Beyond the trial, GPs reverted largely to not intervening, citing barriers that had reportedly been overcome during the trial.

Conclusion: GPs who delivered the intervention had positive experiences doing so, shifting their beliefs modestly that this intervention is important, feasible, and acceptable.

Practice implications: Given that outside of the trial GPs were apprehensive about intervening without a prompt, developing systems to prompt patients may support implementation.

Keywords: Attitude; Obesity; Primary health care; Referral and consultation; Weight loss.