Disparities in Who Receives Weight-Loss Advice From a Health Care Provider: Does Income Make a Difference?
Disparities in Who Receives Weight-Loss Advice From a Health Care Provider: Does Income Make a Difference?
复制标题
谁收到医疗保健提供者的减肥建议的差异：收入有所作为吗？
DOI：
10.5888/pcd13.160183
复制
发表时间：
2016-10-06
影响因子：
5.5
通讯作者：
Ohri-Vachaspati P
中科院分区：
文献类型：
--
作者：
Lorts C;Ohri-Vachaspati P
美国预防服务工作组建议对所有患者进行肥胖筛查，并在必要时提供减肥建议。然而，这种建议的流行率很低，并且因患者人口统计而异。本研究旨在描述在低收入、种族/少数民族人群中接受减肥建议的决定因素。数据收集自2009年和2010年对新泽西州5个城市的1708个家庭进行的电话调查。分析仅限于1109名超重或肥胖的成年人。多变量逻辑回归确定了参与者的特征与接受医疗保健提供者的减肥建议之间的关联。使用两个模型来确定收入和保险状况的差异。在所有超重或肥胖的受访者中，35%的人表示接受过减肥建议。多变量分析显示，接受建议与收入显著相关。与收入等于或低于联邦贫困水平（FPL） 100%的人相比，在FPL的200%至399%之间的人接受建议的几率高出1.60 (P = 0.02)，收入为FPL的400%或以上的人接受建议的几率高出1.73 （P = 0.03）。在调整健康保险后，协会的实力没有改变。在调整人口统计变量、健康状况和保险状况后，收入是超重或肥胖成年人是否接受减肥建议的重要预测因素。需要进一步的工作来研究为什么在接受减肥建议的人群中存在差异。医疗保健提供者应向所有患者提供减肥建议，无论其收入如何。
The US Preventive Services Task Force recommends that all patients be screened for obesity and, if needed, be provided weight-loss advice. However, the prevalence of such advice is low and varies by patient demographics. This study aimed to describe the determinants of receiving weight-loss advice among a sample with a high proportion of low-income, racial/ethnic minority individuals. Data were collected from a telephone survey of 1,708 households in 2009 and 2010 in 5 cities in New Jersey. Analyses were limited to 1,109 overweight or obese adults. Multivariate logistic regression determined the association of participants’ characteristics with receiving weight-loss advice from their health care provider. Two models were used to determine differences by income and insurance status. Of all overweight or obese respondents, 35% reported receiving advice to lose weight. Receiving advice was significantly associated with income in multivariate analysis. Compared with those with an income at or below 100% of the federal poverty level (FPL), those within 200% to 399% of the FPL had 1.60 higher odds of receiving advice (P = .02), and those with an income of 400% or more of the FPL had 1.73 higher odds of receiving advice (P = .03). The strength of the association did not change after adjusting for health insurance. Income is a significant predictor of whether or not overweight or obese adults receive weight-loss advice after adjustment for demographic variables, health status, and insurance status. Further work is needed to examine why disparities exist in who receives weight-loss advice. Health care providers should provide weight-loss advice to all patients, regardless of income.