Maternal obesity: do patients understand the risks?

OBJECTIVE: To evaluate patient knowledge of the risks of maternal obesity and compare knowledge between non-obese and obese women. STUDY DESIGN: A face-to-face survey was administered to 105 women at their first prenatal visit. The survey assessed their knowledge of obesity-related risks during pregnancy, weight history and goals and health behaviors. Descriptive statistics described the entire sample. Student's t-test and chi(2) tests compared knowledge between non-obese (body mass index (BMI) of <30 kg m(-2)) and obese (BMI of > or =30 kg m(-2)) gravidas. RESULT: There were 56 (54%) non-obese and 47 (46%) obese participants. There were no significant differences between the weight groups with respect to age, race, insurance, education, tobacco use and primigravity. Overall, 49% participants knew that obesity increases risks in pregnancy. The knowledge of specific risks was similar in the non-obese (60% correct) and obese (64% correct) groups (P=0.76). Obese patients were more aware of the risk for diabetes (68 vs 96%, P<0.001). Obese gravidas expressed more interest in weight loss before another pregnancy (61 vs 81%, P=0.03), although the desired BMIs (22.1+/-2.3 vs 26.2+/-3.0 kg m(-2), P<0.001) were different for non-obese and obese women, respectively. Of all participants, 9% discussed the risks of maternal obesity with a provider before study participation and 75% wanted to participate in a study on weight loss before pregnancy to determine whether it leads to healthier pregnancies. CONCLUSION: Regardless of BMI category, patients required more knowledge about the risks of obesity in pregnancy, requested additional information and were motivated to lose weight before future pregnancies. Because obese women underestimated their optimal weight loss goals, it is necessary to target this group for further education.

Competency in community-oriented health care. Instrument development.

To competently deal with changes in the health care system, health professionals for the future must have expanded abilities and new attitudes. Education of health professionals for community-oriented health care (COHC) is being promoted as one approach to achieve this focus. This article reports on the development and testing of the Community-Oriented Health Care Competency Scale, which measures knowledge, attitudes, and intention to practice COHC. Results of testing demonstrate adequate reliability for a new instrument: an alpha coefficient of .95 for the Knowledge subscale, .68 for the Attitude subscale, and .93 for the Intention to Practice subscale. Content Validity of the instrument is based on the literature review, focus group sessions, and expert opinion. The instrument may be used to assess competency of health professions students in COHC, but continued testing is needed.