Primary Care Resident Training for Obesity, Nutrition, and Physical Activity Counseling: A Mixed-Methods Study

Elizabeth L. Antognoli, Eileen L. Seeholzer, Heidi Gullett, Brigid Jackson, Samantha Smith, Susan A. Flocke

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


National guidelines have been established to support the role of primary care physicians in addressing obesity. Preparing primary care residents to recognize and treat overweight/obesity has been identified as an essential component of postgraduate medical training that is currently lacking. This study aims to identify how primary care residency programs are preparing physicians to counsel about obesity, nutrition, and physical activity (ONPA) and to examine program members’ perspectives regarding the place of ONPA counseling in the curriculum, and its relevance in primary care training. Using mixed methods, we collected and analyzed data on 25 family medicine, internal medicine, and obstetrics/gynecology residency programs across Ohio. Programs averaged 2.8 hours of ONPA-related didactics per year. Ten programs (42%) taught techniques for health behavior counseling. Having any ONPA-related didactics was associated with greater counseling knowledge (p =.01) among residents but poorer attitudes (p <.001) and poorer perceived professional norms (p =.004) toward ONPA counseling. Findings from interview data highlighted similar perceived barriers to ONPA counseling across all three specialties but variation in perception of responsibility to provide ONPA counseling. While widespread expectations that primary care physicians counsel their overweight and obese patients prevail, few residency programs provide training to support such counseling.

Original languageEnglish (US)
Pages (from-to)672-680
Number of pages9
JournalHealth promotion practice
Issue number5
StatePublished - Sep 1 2017
Externally publishedYes


  • health promotion
  • medical education
  • obesity
  • primary care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)


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