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Incorporating culture and social determinants as we partner with patients with obesity, with dietician and epidemiologist Dr. Shreela Sharma and patient representative Ms. LaToshia Rouse.
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Learning Objectives
1. Give an example of how one’s culture can shape one’s perceptions of weight.
2. List 3 potential questions that can be used to humbly and sensitively elicit a patient’s individual and cultural perceptions of weight and their particular weight goals.
3. Compare and contrast certain cultural groups’ variable receptivity to different obesity interventions.
4. Evaluate how adverse childhood experiences (ACEs) and social determinants of health can lead to obesity.
5. Describe some positive steps being taken by healthcare systems to address social determinants and improve their patients’ ability to live healthy lives.
2. List 3 potential questions that can be used to humbly and sensitively elicit a patient’s individual and cultural perceptions of weight and their particular weight goals.
3. Compare and contrast certain cultural groups’ variable receptivity to different obesity interventions.
4. Evaluate how adverse childhood experiences (ACEs) and social determinants of health can lead to obesity.
5. Describe some positive steps being taken by healthcare systems to address social determinants and improve their patients’ ability to live healthy lives.
Show Notes
[00:00-01:11] Introduction
[01:11-01:54] Introduction to Guests
[01:54-06:41] Cultural Perceptions of Weight
[12:40-16:02] Variable Receptivity Amongst Distinct Social Groups to Different Interventions
[16:02-20:13] Research on the Effects of Social Determinants of Health
[20:13-23:00] Challenges that Patients and their Families May Face with Healthy Eating
[22:36-26:29] Advocating For and Working Towards Health Equity
[26:29-28:12] Closing
Course Director and Senior Producer: Dr. Maggie Kozman
Co-Hosts: Dr. Pooja Jaeel and Likitha Aradhyula
Guests: Dr. Shreela Sharma and Ms. LaToshia Rouse
Production Assistant: Lynn Nguyen
Special thanks to Dr. Davoren Chick, Monica Lizarraga, Dr. Charles Hamori, Dr. Tammy Lin, Dr. Tiffany Leung, and Darian Harris for helping to make this project possible.
- Introduction to co-hosts and episode
[01:11-01:54] Introduction to Guests
- Dr. Shreela Sharma, an epidemiologist and a dietician, who does work in food insecurity, obesity prevention, and health disparities research
- Ms. LaToshia Rouse, a patient representative in numerous capacities, especially when it comes to maternal and infant health and patient engagement
[01:54-06:41] Cultural Perceptions of Weight
- Honor and celebrate the cultural nuances and perceptions regarding weight instead of viewing them as barriers.
- Dieticians and healthcare providers need to ask better questions to work within the patients’ cultural nuances to help them on their journey.
- Flavor, taste, and culture are important mediators of behavior change.
- Traditional foods are healthier than westernized diets.
- Providers need to talk and really listen to patients in order to understand their familial and cultural backgrounds and perceptions of weight before recommending interventions.
- This conversation should not just be a one-time thing, but an ongoing process.
- Focus on being healthy, not on becoming a certain universal size.
- Ask about the patient’s goals, their ideal size, etc.
- Talk about the patient’s access to food and cooking appliances, and about their food environment.
[12:40-16:02] Variable Receptivity Amongst Distinct Social Groups to Different Interventions
- Food is a need, not a want.
- Food insecurity, disordered eating patterns, and spending trade-offs affect distinct cultural groups to varying degrees and, therefore, impact those groups’ receptivity to different treatments.
- ISMART framework for setting lifestyle modification goals with patients
- Sex and racial differences are present in patients’ reported quality of life relative to BMI and receptivity to bariatric surgery.
- Gender and racial differences are dissipated when adjusted for socioeconomic factors.
[16:02-20:13] Research on the Effects of Social Determinants of Health
- Food insecurity and food deserts, a history of trauma, and living in a neighborhood with high violence or crime affect a patient with obesity’s ability to achieve a healthy weight
- ACEs study showed that adverse childhood experiences increase the likelihood of developing obesity.
- An early lifecycle approach to obesity prevention can break the cycle of obesity in families. Next steps in obesity prevention: altering early life systems to support healthy parents, infants, and toddlers by Dr. Phillip Nader, et al.
[20:13-23:00] Challenges that Patients and their Families May Face with Healthy Eating
- Money factors into a patient’s idea of healthy eating.
- Unhealthy, processed junk food and fast food are convenient, are cheap, and taste good.
- Healthcare providers and patients need to share information specific to each patient’s situation
[22:36-26:29] Advocating For and Working Towards Health Equity
- Healthcare systems and providers implementing food prescription programs in partnership with food banks and grocery stores
- Providers advocating for patients inside and outside of the clinical setting
- Providers thinking about these issues through a social justice and equity lens, as described by Dr. Shiriki Kumanyika
[26:29-28:12] Closing
- Website: www.thedeishift.com
- Twitter/Instagram: @TheDEIShift
- Theme Music: www.chrisdingman.com
Course Director and Senior Producer: Dr. Maggie Kozman
Co-Hosts: Dr. Pooja Jaeel and Likitha Aradhyula
Guests: Dr. Shreela Sharma and Ms. LaToshia Rouse
Production Assistant: Lynn Nguyen
Special thanks to Dr. Davoren Chick, Monica Lizarraga, Dr. Charles Hamori, Dr. Tammy Lin, Dr. Tiffany Leung, and Darian Harris for helping to make this project possible.
