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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 1  |  Page : 20-24

Knowledge and training needs of primary healthcare physicians regarding obesity management in Saudi Arabia


1 General Directorate for the Prevention of Genetic and Chronic Diseases, Asser, KSA
2 Department of Family Medicine, Asser, KSA
3 Public Health Institute Federal Ministry of Health, Riyadh, Saudi Arabia
4 Collage of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
5 Research Unit, KAIMRC, NGHA, Riyadh, Saudi Arabia

Date of Web Publication29-Jun-2016

Correspondence Address:
Shaker A Alomary
Director of the Obesity Control Program, General Directorate for the Prevention of Genetic and Chronic Diseases, Asst. Deputy of Public Health G, Ministery of Health
KSA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2347-2618.184952

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  Abstract 

Background: Obesity in Saudi Arabia is reaching an alarming level and hence the role of primary healthcare physicians becomes a necessity. Objective: This study aims to evaluate primary health care knowledge and the training needs with respect to managing obesity in Saudi Arabia. Methods: A questionnaire based cross-sectional survey was conducted among PHCC physicians in Saudi Arabia between May and October 2014. Questionnaire consisted of three parts; demographic data, questions about basic knowledge on obesity and training needs of PHCC physician regarding obesity. Questionnaire was distributed to selected physicians and response by ordinary mail through technical supervisors in general directorates all over KSA. Data entry and analysis were s carried out using SPSS. Results: Seven Hundred and seven physicians completed the questionnaire and returned it to the investigator. General knowledge about obesity was acceptable, as most of questions were answered correctly, 83.6% of the physicians had not received any specialized course or training on obesity. Priority of training requested by physicians was psychotherapy, medications (88%), counseling on nutrition/exercise (84%), and surgical therapy (75%). The difference regarding needs for training was not significantly different in relation to gender and nationality. Conclusion: This nationwide survey found that physicians had acceptable knowledge towards the management of obesity and overweight, however, they need to have more training regarding prevention and management of obesity.

Keywords: Knowledge, obesity, obesity management, overweight, primary healthcare physician0 , Saudi Arabia


How to cite this article:
Alomary SA, Saeedi MY, Alotaibi TM, Al Shehri FS, Bashir AO, Ali AZ, El-Metwally AA. Knowledge and training needs of primary healthcare physicians regarding obesity management in Saudi Arabia. Saudi J Obesity 2016;4:20-4

How to cite this URL:
Alomary SA, Saeedi MY, Alotaibi TM, Al Shehri FS, Bashir AO, Ali AZ, El-Metwally AA. Knowledge and training needs of primary healthcare physicians regarding obesity management in Saudi Arabia. Saudi J Obesity [serial online] 2016 [cited 2019 Nov 14];4:20-4. Available from: http://www.saudijobesity.com/text.asp?2016/4/1/20/184952


  Introduction Top


Worldwide, noncommunicable diseases (NCDs) have become big burden on health-care system and a major cause of mortality. According to the World Health Organization (WHO), a total of 57 million deaths occurred in the world during 2008; 36 million (63%) were due to NCDs. [1] Globally, 2.8 million people die each year as a result of being overweight and obesity. [2] In the Middle East region, 45% and 20% of adults suffer from overweight and obesity, respectively. [3] In Saudi Arabia, the magnitude of obesity increases. A community-based national epidemiological health survey conducted in 1997 showed that the prevalence of obesity was 13.05% and 20.26% in males and females, respectively. [4] In 2005, an another national survey conducted among 17,232 Saudi subjects found that the prevalence of obesity was 35.5%. [5] A recent national study conducted in Saudi Arabia in 2013 revealed that the prevalence of obesity was 33.5% among females and 24.1% among males. [6]

This worldwide pandemic of obesity puts up a great challenge in front of public health authorities all over the world. [7] Despite the vital roles of primary health-care physicians in prevention and management of obesity, [8],[9],[10] a few regional studies were conducted in Saudi Arabia to explore this area. [11],[12],[13]

This study aims to assess the knowledge of primary health-care physicians and their training needs with respect to obesity management in Saudi Arabia.


  Methods Top


This study was conducted among primary health care physician working in Primary Health Care Centers in Saudi Arabia between May and October 2014. A Self-administered questionnaire was disturbed to a representative sample of these physicians.

Using RAO software, a sample size was estimated with 0.05 alpha, confidence interval of 95% and total population physician at primary health care of 7000 physicians, sample size was 368 physicians. To compensate low response rate, 736 physicians were invited to participate in this study all over 13 General Directorates of Health Affairs in the Kingdom.

Multi -stage sampling technique was used to select different primary health care centers and from each selected centers, working primary health care physician was chosen to participated in this study.

A self-administered questionnaire was adopted by investigators based on a study conducted in Kuwait. [14] The Questionnaire consists of the following parts; Demographics about the participants, Questions about prevalence of obesity, health risk of obesity and approved medications. Participants were asked to answer questions accordingly: T for true statements, F for false statements, and DK if they do not know the answers, knowledge regarding obesity was considered acceptable if the total score was greater than 80%. The third part was about the current source of information about obesity, training needs and preferred methods for training in the future regarding management of obesity.

Ethical approval from the regional ethical committee was obtained to conduct this study. Data of questionnaire was coded, then entered and analyzed by using Statistical Package for the Social Sciences (SPSS) version 20 appropriate tests were used and P values were consisted as significant if less than 0.05.


  Results Top


The questionnaire was completed by 707 physicians. Socio-demographic characteristics are shown in [Table 1], age of majority of participants was between age 25-35 years (47.0%), males represent 54.5%, non-Saudi 65.1%, those without post MBBS qualification (72.1%). Regarding knowledge about obesity, about 32% did not know the prevalence of obesity in Saudi Arabia.
Table 1: Sociodemographic characteristics of study population (n=707)


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Eighty percent were able to know definitions of overweight, obesity, and morbid obesity while 55% gave correct response regarding indications for obesity surgeries. Most of the participants (80%) were able to give correct answers regarding the risk and consequences of obesity. Most of the participants responded correctly regarding the impact of weight reduction on different obesity-related morbidities [Figure 1]. [Table 2] shows the association between some demographic variables and training needs among participants. Statistical analysis could not find any association between gender/nationalities and different training topics of obesity.
Figure 1: Bar graph showing percentages of true responses regarding knowledge of primary health care physicians about the diseases that can be controlled by weight reduction

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Table 2: Obesity related training according to gender and nationality among primary care physicians, Saudi Arabia, 2014


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[Figure 2] displays the main sources of information used by participants; more than 50% have used Internet and continuing medical education programs, 48% used clinical guidelines while 45% used medical journals. [Figure 3] depicts the obesity-related topics of high priority for training among PHCC doctors. Psychotherapy and counseling on nutrition/exercise were the most important subjects for training (88% and 84%, respectively), followed by pharmacotherapy (88%) and bariatric surgery (75%).
Figure 2: Bar graph showing the percentages of main source of information regarding obesity among PHCC doctors, KSA

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Figure 3: Bar graph showing the percentages of primary health care physicians required training in topics related to obesity management

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  Discussion Top


Primary health care physicians can play a very vital role in the prevention and management of the obesity and overweight as they are the first-line of contact in health care settings. As recommended primary health care physicians, and not specialists, should be the first-line of management of obesity to improve the prognosis of this common condition by reducing the impact of consequences of obesity and its significant economic burden. [15],[16],[17]

Our results showed that primary health care physicians have good knowledge regarding management of obesity. The results of this study are consistent with the results of studies conducted in different parts of the world and also with the results of studies conducted in the Middle East. [11],[12],[13],[14],[15],[16],[17],[18],[19]

Like other studies, primary health care physicians were interested in getting training related to psychological treatment, drug treatment, and counseling about nutritional and physical activity. [14],[18] The main source of information was through internet. Unlike previous study, our study reported that around 45% of primary health care physicians used journals for information regarding obesity and its management. The previous study reported that only 28.5% consulted journals. [12] This rise in the usage among primary health care physicians indicates the urge of knowledge toward the management. [12] Like the study conducted in 2013 in Saudi Arabia and in 2012 in Kuwait, our study also reported that very few primary health care physicians were trained for the management of obesity. [12],[14] This lack of training can hinder the better management as training provides knowledge about recent development and day-to-day advancement in the management of obesity and overweight and also it provides a different tool which can be used by the physicians to improve their day-to-day practices. Thus, it is crucial to promote such training for better management of such chronic problem and its comorbidities.

This study has few limitations as it was a questionnaire-based survey, the knowledge was self-reported that might have cause biased information. Nevertheless, this study has some strengths that include recruitment of participant different centers nationwide that is help in the generalization of our findings and give overview about the knowledge of different primary health care physician working in different centers.


  Conclusion Top


This study found that physicians had acceptable amount of knowledge regarding the management of obesity and overweight. However, they are in need of effective and evidenced-based training program to upgrade their knowledge and skills to manage obesity at PHCC settings in the KSA.

Acknowledgments

We would like to acknowledge all the primary health care centers and physicians for participating in the study, and the 20 district coordinators for Obesity Control Program as well as the Obesity Control Program in the General Directorate for the Prevention of Genetic and Chronic Diseases for all the support.

Financial support and sponsorship

This research was supported and funded by the Obesity Control Program at the General Directorate for the Prevention of Genetic and Chronic Diseases.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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Alwan A, MacLean DR, Riley LM, d′Espaignet ET, Mathers CD, Stevens GA, et al. Monitoring and surveillance of chronic noncommunicable diseases: Progress and capacity in high-burden countries. The Lancet 2010;376:1861-8.  Back to cited text no. 1
    
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El-Hazmi MA, Warsy AS. Prevalence of obesity in the Saudi population. Ann Saudi Med 1997;17:302-6.  Back to cited text no. 4
    
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Memish ZA, El Bcheraoui C, Tuffaha M, Robinson M, Daoud F, Jaber S, et al. Obesity and Associated Factors - Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 2014;11:140-236.  Back to cited text no. 6
    
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Bocquier A, Verger P, Basdevant A, Andreotti G, Baretge J, Villani P, et al. Overweight and obesity: Knowledge, attitudes, and practices of general practitioners in France. Obes Res 2005;13:787-95.  Back to cited text no. 8
    
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Al-Muammar MN. Predictors of physicians′ practices related to nutritional counseling and management in Riyadh city. Alex J Med 2012;48:67-74.  Back to cited text no. 11
    
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Al-Khaldi YM, Abu Melha WS, Al-Shahrani AM, Al-Saleem SA, Hamam MA. Knowledge, attitude and practice of primary health care physicians in Aseer region regarding obesity. Saudi J Obesity 2014;2:54-8.  Back to cited text no. 13
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Al-Najjar AA, Al-Jasem NJ, Al-Quraini YF, Salama O, El-Shazly MK. Knowledge and attitude of primary health care physicians towards obesity management, Kuwait. Greener J Med Sci 2012;2:120-9.  Back to cited text no. 14
    
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National institute of health, national heart lung and blood institute. Clinical guidance on the identification, evaluation and treatment of overweight and obesity in adults. Betheseda MD, national institute of health; 1998.  Back to cited text no. 15
    
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Bocquier A, Verger P, Basdevant A, Andreotti G, Baretge J, Villani P, et al. Overweight and obesity: Knowledge, attitudes, and practices of general practitioners in France. Obes Res 2005;13:787-95.  Back to cited text no. 16
    
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Ferrante JM, Piasecki AK, Ohman-Strickland PA, Crabtree BF. Family physicians′ practices and attitudes regarding care of extremely obese patients. Obes 2009;17:1710-6.  Back to cited text no. 17
    
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Story MT, Neumark-Stzainer DR, Sherwood NE, Holt K, Sofka D, Trowbridge FL, et al. Management of child and adolescent obesity: Attitudes, barriers, skills, and training needs among health care professionals. Pediatrics 2002;110:210-4.  Back to cited text no. 18
    
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Fogelman Y, Vinker S, Lachter J, Biderman A, Itzhak B, Kitai E. Managing obesity: A survey of attitudes and practices among Israeli primary care physicians. Int J Obes 2002;26:1393-7.  Back to cited text no. 19
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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