Patient and obstetric provider communication regarding weight gain management among socioeconomically disadvantaged African American women who are overweight/obese

ABSTRACT

To examine the communication between obstetric providers and their socioeconomically disadvantaged, African American patients who are overweight and obese during pregnancy, and whether this communication relates to outcomes. Pregnant patients and their obstetric providers were surveyed between October 2012 and March 2016 at Washington University School of Medicine in St. Louis, MO. Percent agreement between patients’ and obstetric providers’ survey responses was analyzed and measured (κ coefficient). Descriptive and multilevel logistic regression analyses aimed at identifying the relation of perceived communication between providers and patients to gestational weight gain, diet, and exercise during pregnancy. A total of 99 pregnant women and 18 obstetric providers participated in the study. Significant lack of agreement was observed between patients and obstetric providers regarding communication about weight gain recommendations, risk factors associated with excessive weight gain, what constitutes adequate exercise per week, exercise recommendations, dietary recommendations, and risk factors associated with a poor diet. Our findings suggest patients were not receiving intended messages from their obstetric providers. Thus, more effective patient-obstetric provider communication is needed regarding gestational weight gain, exercise and dietary recommendations among overweight/obese, socioeconomically disadvantaged, African American women.

KEYWORDS:

• Gestational weight gain
• patient-provider communication
• pregnancy

Acknowledgments

LIFE-Moms is supported by the National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, U01 DK094418, U01 DK094463, U01DK094416, 5U01DK094466 (RCU)), the National Heart, Lung, and Blood Institute (NHLBI, U01HL114344, U01HL114377), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, U01 HD072834), the National Center for Complementary and Integrative Health (NCCIH), the NIH Office of Research in Women’s Health (ORWH), the Office of Behavioral and Social Science Research (OBSSR), the Indian Health Service, and the Intramural Research Program of the NIDDK. We thank LIFE-Moms consortium members for their contributions to the development and oversight of common measures and procedures across the trials. This publication was supported by the Washington University Institute of Clinical and Translational Sciences (UL1 TR000448), the National Center for Advancing Translational Sciences (TL1 TR000449) and the National Institute of Diabetes and Digestive Kidney Diseases (DK DK094416). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

National Center for Complementary and Integrative Health;National Heart, Lung, and Blood Institute [NHLBI, U01HL114344, U01HL114377]; National Institute of Diabetes and Digestive and Kidney Diseases [U01 DK094418, U01 DK094463, U01DK094416, 5U01DK094]; Eunice Kennedy Shriver National Institute of Child Health and Human Development [U01 HD072834]; National Center for Advancing Translational Sciences [TL1 TR000449]; Washington University in St. Louis Institute for Clinical and Translational Sciences [UL1 TR000448].