Racial Disparities in Physician Practice Patterns and Self-Management of Obesity

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Sara N. Bleich, PhD is an Assistant Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. This proposed NHLBI Mentored Career Development Award (K01) will provide the necessary support to facilitate Dr. Bleich's sucessful transition to an independent researcher in the field of obesity-related health care disparities. Dr. Bleich's long-term objective is to reduce health care disparities in the delivery and use of obesity-related services among vulnerable, high risk populations. The proposed training plan includes a series of learning activities to increase the candidate's knowledge of the theoretical underpinning of health care disparities and the clinical management of obesity as well as to develop new skills in data analysis (e.g., multilevel modeling, claims data, qualitiative data analysis),survey development, and intervention design/implementation methods. Building on these learning objectives, two types of research will be pursued during the award period - secondary analyses and primary data collection. Project aims for the secondary analyses are: to examine Black-White racial disparities in physician practice patterns of obesity care, using nationally representative and health plan data (Aim 1) and to identify the multilevel explanatory factors underlying racial disparities in individual self-management of body weight, using regional data (Aim 2). Primary data will be collected via focus groups. Focus groups will be conducted with obese patients, their families, health professionals and administrators to determine key patient- and provider-level barriers to optimal obesity care, whether they differ by patient race, and how these barriers can be overcome(Aim 3). This proposed career development plan is designed to provide Dr. Bleich with the additional experience and resources necessary to support the submission of a sucessful grant application (e.g., R01) to further explore racial disparities in physician practice patterns and self-management of body weight in a health plan population and to develop the necessary evidence base to mount effective interventions to improve adult obesity care in that setting. Reducing obesity and eliminating health disparities are both federal priorities. This project and future planned studies will contribute to that effort. RELEVANCE (See instructions): Obesity disproportionally impacts minority populations, represents an enormous public health challenge, and is under-managed by physicians and patients. In light of the current federal priorities to reduce obesity and eliminate health disparities, there is a need to better understand racial disparities in practice patterns of obesity care and the multilevel explanatory factors underlying patient self-management of weight.