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Title: Development and feasibility of an objective measure of patient-centered communication fidelity in a pediatric obesity intervention

Author
item LEDOUX, TRACEY - University Of Houston
item HILMERS, ANGELA - Children'S Nutrition Research Center (CNRC)
item WATSON, KATHY - Children'S Nutrition Research Center (CNRC)
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)
item O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal of Nutrition Education and Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/1/2012
Publication Date: 7/1/2013
Citation: Ledoux, T., Hilmers, A., Watson, K., Baranowski, T., O'Connor, T.M. 2013. Development and feasibility of an objective measure of patient-centered communication fidelity in a pediatric obesity intervention. Journal of Nutrition Education and Behavior. 45(4):349-354.

Interpretive Summary: Person-centered communication (PCC) is a technique that emphasizes listening to patients concerns, and is believed to be important for enhancing patients behavior change. A PCC coding system (PCCCS) was developed to assess whether health educators who delivered an obesity treatment program for preschool children in clinics employed PCC (which is what they were trained to use). The PCCCS demonstrated acceptable reliability from audiotapes of interactions with patients for specific types of statements. More research is needed to refine the coding categories and procedures.

Technical Abstract: Our objective was to develop a measure of person-centered communication (PCC) and demonstrate feasibility for use in primary care child obesity interventions. Helping Healthy Activity and Nutrition Directions was a primary care intervention for families of overweight or obese 5- to 8-year-old children. The PCC Coding System (PCCCS) was based on theory and a validated motivational interviewing instrument. The PCCCS provided global scores, and total, positive, and negative PCC utterance frequencies. Three trained coders tested reliability of the PCCCS on audio recordings of sessions with 30 families. Potential uses of the PCCCS were demonstrated. The PCCCS demonstrated good inter-rater reliability for utterance frequencies but not for global scores. We concluded the PCCCS is a reliable and feasible measure of PCC utterances. More research is needed to improve inter-rater reliability of the PCC global scale. The PCCCS may be used in the future to test fidelity of PCC interventions.