Psychosocial Factors that Inform the Decision to Have Metabolic and Bariatric Surgery Utilization in Ethnically Diverse
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ORIGINAL CONTRIBUTIONS
Psychosocial Factors that Inform the Decision to Have Metabolic and Bariatric Surgery Utilization in Ethnically Diverse Patients Juang Keeton 1 & Ashley Ofori 1 & Quiera Booker 1 & Benjamin Schneider 2 & Carrie McAdams 3 & Sarah E. Messiah 1,4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Metabolic and bariatric surgery (MBS) is currently the only clinically proven method of weight loss that is effective in treating severe obesity and its related comorbidities. However, only about 36% of MBS-eligible patients complete MBS. This qualitative study used the psychosocial framework to identify barriers and facilitators to MBS utilization among patients who had been referred to, or were considering MBS, but had not completed it. Methods A combination of focus groups and in-depth interviews were utilized (Spring 2019) among ethnically diverse patients (N = 29, 82% female, 62% non-Hispanic Black, 10% Hispanic) who were considering MBS. All data was audio recorded, transcribed, and coded. Interview questions were grouped by the four psychosocial model domains (intrapersonal, interpersonal, organization/clinical interaction, societal/environmental) within the context of why patients would/would not follow through with MBS. The analysis included a combination of deductive and inductive approaches to generate the final codebook. Then, each code was input into Dedoose to identify overarching themes and sub-themes. Results A total of 9 themes and 17 subthemes were found. Two major intrapersonal themes and four subthemes were identified as facilitators to MBS utilization and included a desire for improvement in existing comorbidities, mobility, and anticipated changes in physical appearance. Primary barriers to MBS completion included concerns about potential change in dietary behaviors postMBS and safety of procedure. Conclusions Providing educational materials to address MBS common fears and misconceptions may increase utilization rates. Providing community-based pre- and post-support groups for this patient population may also increase MBS completion rates. Keywords Metabolic . Bariatric surgery . Ethnicity . Health disparities . Psychosocial model . Utilization
Introduction Currently, metabolic and bariatric surgery (MBS) is the only clinically proven method of treating both obesity and obesity-related comorbidities [1–5]. Moreover,
* Sarah E. Messiah [email protected] 1
School of Public Health, University of Texas Health Science Center at Houston, Dallas, TX, USA
2
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
3
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
4
Paul M. Bass Administrative and Clinical Center, University of Texas Southwestern Medical Center, 6363 Forest Park Road, BL10.204, Dallas, TX 75390, USA
studies have shown that MBS can be more effective at maintaining long-term weight loss compared with lifestyle interventions alone [4, 6]. Howeve
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