Prospective association between body mass index and receipt of preventive services: Results from the Central Pennsylvania Women's Health Study (CePAWHS)

Objective: We examine whether overweight and obesity are associated with disparities in clinical preventive services receipt in a unique, prospective, population-based cohort of reproductive-age women. Method: We used data from the Central Pennsylvania Women's Health Study (CePAWHS) longitudinal survey of women ages 18-45. The baseline random-digit-dial telephone survey was conducted in 2004-2005 and a second telephone interview two years later; 1342 participants comprised the analytic sample. Dependent variables were seven preventive services identified at follow-up. In addition to baseline body mass index (BMI) category, independent variables were selected based on the behavioral model of health services utilization. Results: Forty-six percent of the sample was classified as normal weight, 28% as overweight, and 26% as obese. In adjusted analyses, women who were overweight and obese, compared to women with normal weight, were more likely to receive preventive counseling for diet/nutrition, physical activity, and weight management (p < 0.01). Overweight and obese women received more cholesterol and diabetes screening (p < 0.05 and p < 0.01, respectively). However, there were no differences by BMI category in receipt of Pap testing or reproductive counseling. Conclusion: Overall, we found that women with overweight and obesity were more likely to receive preventive services, especially services relevant for overweight and obese populations.