The Behavioral Mechanism Of Community Healthcare Professionals In Implementing Adult Weight Management Practice: The Construction Of Conceptual Framework

BackgroundThe prevalence of overweight and obesity in China has increased with aninconceivable speed. Overweight and obesity may cause a range of health, social andpsychological problems, the rapid growing is bound to have an adverse effect on the healthof our population, overweight and obesity has become an important public health problemof China. The community healthcare professionals are at the position of prevent overweightand obesity. However, studies showed that their behaviors are poor, and there are no suitableexplanatory variables. Therefore, this study will attempt to construct a conceptualframework of community healthcare professionals in implementing adult weightmanagement.ObjectivesThe present study attempted to construct a conceptual framework of communityhealthcare professionals in implementing adult weight management through the use ofmultiple research methods. In this process you can gain an in-depth understanding of factorsthat influence community healthcare professionals’ beliefs and practices, and then, developa preliminary measurement tool of this framework. This study will provide the basis forfurther improvement of healthcare professionals’behavior.MethodsThe research process comprised the following stages:Stage1: Literature review of factors affecting domestic and foreign medicalprofessionals’ weight management behaviors; comprehensive analysis the application ofsocial psychology in the medical personnel professional behavior to get the appropriatebehavior theories and concepts.Stage2: Qualitative research methods with general practioners, distinct nurses,administrators and community residents. By means of theoretical domains framework(Theoretical Domain Framework, TDF), we get the initial domains and concepts related tothe behaviors of weight management and develop corresponding questionnaire entries.Through discussion, the experts evaluate the initial outcomes and identify a set ofpsychological theories and models that best represented the constructs from the relevantdomains. Stage3: Combining the results of literature review and qualitative interview, weultimately establish hypothesis model for weight management conceptual framework ofcommunity medical professionals and preliminary measurement tools of the model.Results:1. Literature study result showed that:(1) Medical professionals (including doctors andnurses) are generally agreed that the importance and necessity of weight management, buttheir behaviors are poor.(2) Factors affecting medical professionals’ weight managementbehaviors are: demographics (gender, age, their weight, geography, ethnicity), occupationalfactors (professional, work experience, knowledge and training), attitudes and beliefsfactors (self-efficacy, outcome expectations, obesity discrimination and prejudice, roleidentity, perceived barriers), and patient factors (patient intention, severity of obesity andcomorbidities).(3)Theory of planned behavior（TPB）and its expansion may be the mostsuitable theory to explain and predict the behavior of medical professionals.2. The qualitative interview showed that：(1)The final themes of community healthcare professionals in implementing adultweight management can be divided into seven conceptual domains of17concepts.Specifically including knowledge and skills (knowledge, skills, skill development, practice);social/professional role identity (professional role identity); beliefs about capabilities(self-efficacy, perceived behavioral control); beliefs about consequence (consequence,expected outcome, beliefs); intention (intention stability, intention); environmental contextand resource (environmental stressors, resources or materials); social influence(social stress,social support, power). These factors reveal the behavior process from the individual,interpersonal and social level, and in this process the community medical staff, clients(mostly patients), the organizational factors (mainly from the leadership) and environmentalfactors (environment and resources).are the main players.(2) TPB, SCT, KAP, HBM are the right theories related to17concepts, in particularTPB and SCT can explain most of the concepts.3. Combined the results of literature review and qualitative interview, we confirm thefactors of influence community healthcare professionals behavior. Based on the SCT andTPB concepts relationship, and logical reasoning the relationship of precipitateddomains/concepts, we construct a conceptual framework. Based on the framework and theliterature study results, we develop the initial formation questionnaires which contains102entries. Conclusion:1. The behavior of community healthcare professionals’in adult weight management isnot ideal, it may be the interaction result of a variety of factors among the individual,interpersonal and social environment. The nested conceptual framework of TPB and SCTmay help us to understand the behavior of community healthcare professionals in adultweight management.2. Community medical staffs generally considered that their lack of knowledge andskills, the population low awareness in health weight, and the national policy does notsupport in weight management, the intervention is difficult to succeed. Therefore, we needto strengthen the training of community health workers, raise awareness of the populationwith the help of social media disseminate; policy adjustment and support to promote thecommunities in weight management activities.