A longitudinal study of changes in noticing and treating patients' overweight by Dutch GPs between 1997 and 2007.

BACKGROUND One of the stakeholders in tackling the rise and health consequences of overweight and obesity is the general practice physician (GP). GPs are in a good position to inform and give nutrition guidance to overweight patients. OBJECTIVE Assessment of working mechanism of determinants of the nutrition guidance practice: noticing patients' overweight and guidance of treatment by GPs [linear analysis of structural relations (LISREL) path model] in a longitudinal study. METHODS This longitudinal study measured data in 1992, 1997 and 2007. The 1992 LISREL path model (Hiddink GJ, Hautvast J, van Woerkum CMJ, Fieren CJ, van t'Hof MA. Nutrition guidance by primary-care physicians: LISREL analysis improves understanding. Prev Med 1997; 26: 29-36.) demonstrated that 'noticing patients' overweight and guidance of treatment' was directly and indirectly influenced by predisposing factors, driving forces and perceived barriers. This article defines and discusses the path analysis of the 2007 data (compared with 1997). RESULTS This analysis shows both similarity and differences in working mechanism of determinants of noticing patients' overweight and guidance of treatment between 1997 and 2007. The backbone of the mechanism with four predisposing factors is the similarity. The number of driving forces and of paths through intermediary factors to the dependent variable constitutes the difference. CONCLUSIONS The backbone of the working mechanism of determinants of the nutrition guidance practice: noticing patients' overweight and guidance of treatment by GPs was similar in 2007 and 1997. The influence of GPs task perception on noticing patients' overweight and guidance of treatment considerably increased in 2007 compared to 1997. The longitudinal character of this article gives a strong practice-based evidence for weight management by GPs.