Procedural Fairness in Physician–Patient Communication: A Predictor of Health Outcomes in a Cohort of Adults with Overweight or Obesity

Background: This study aimed to explore whether patients’ perception of procedural fairness in physicians’ communication was associated with willingness to follow doctor’s recommendations, self-efficacy beliefs, dietary behaviors, and body mass index. Methods: This was a secondary analysis of baseline data from 489 primary care patients with a BMI ≥ 25 kg/m² (43.6% Black, 40.7% Hispanic/Latino, 55.8% female, mean age = 50 years), who enrolled in a weight management study in two New York City healthcare institutions. We conducted ordinary least squares path analyses with bootstrapping to explore direct and indirect associations among procedural fairness, willingness to follow recommendations, self-efficacy, dietary behaviors, and body mass index, while controlling for age and gender. Results: Serial, multiple mediator models indicated that higher procedural fairness was associated with an increased willingness to follow recommendations which, in turn, was associated with healthier dietary behaviors and a lower BMI (indirect effect = −.02, SE =.01; 95% CI [−.04 to −.01]). Additionally, higher procedural fairness was associated with elevated dietary self-efficacy, which was, in turn, was associated with healthier dietary behaviors and lower BMI (indirect effect = −.01, SE =.003; 95% CI [−.02 to −.002]). Conclusions: These findings highlight the importance of incorporating procedural fairness in physician–patient communication concerning weight management in diverse primary care patients.