Physician weight loss advice and patient weight loss behavior change: a literature review and meta-analysis of survey data.

Primary care providers (PCPs) can empower their patients to make health-promoting behavior changes. Many guidelines recommend that PCPs counsel overweight and obese patients about weight loss, yet few studies examine the impact of provider weight loss counseling on actual changes in patient behavior. We performed a systematic review and meta-analysis of published studies of survey data examining provider weight loss counseling and its association with changes in patient weight loss behavior. We reviewed the published literature using keywords related to weight loss advice. We used meta-analytic techniques to compute and aggregate effect sizes for the meta-analysis. We also tested variables that had the potential to moderate the responses. A total of 32 studies met criteria for the literature review. Of these, 12 were appropriate for the meta-analysis. Most studies demonstrated a positive effect of provider weight loss advice on patient weight loss behavior. In random effects meta-analysis, the overall mean weighted effect size for patient weight loss efforts was odds ratio (OR)=3.85 (95% confidence interval (CI) 2.71, 5.49; P<0.01), indicating a statistically significant impact of weight loss advice. There was no significant difference in the effectiveness of advice in studies using obese patients alone versus mixed samples (obese alone OR=3.44, 95% CI 2.37, 5.00; mixed sample OR=3.98, 95% CI 2.53, 6.26, P=0.63). PCP advice on weight loss appears to have a significant impact on patient attempts to change behaviors related to their weight. Providers should address weight loss with their overweight and obese patients.

An interventionist's guide to AIDS behavioral theories.

Although numerous individual-level AIDS behavioral theories (ABTs) exist in the literature, there is currently no consensus as to which theory is most precise in explaining or predicting HIV risk behavior. In the absence of empirical evidence favoring one ABT over another, how should an interventionist go about choosing a theory for one's particular prevention efforts? The current article provides an overview of and conceptually compares 13 ABTs in an attempt to provide guidance regarding this critical decision. A variety of criteria upon which one might judge ABTs are proposed and discussed, including empirical support for variables that make up the theory, whether or not theories are belief-based, AIDS-specific, message-based, intervention-based and behavior or behavioral-change focused. While all of the theories have strengths and weaknesses, the task for an interventionist is to choose the theory of best fit for one's particular prevention efforts. The suggestions provided in the current article may help with such a choice.