Using Factorial Survey Design with photographs to explore multiprofessional clinical decision-making in obesity management research

Obesity is a significant global risk factor for cardiovascular disease (CVD) and attributed to two-thirds of mortality linked to CVD worldwide. Expert position papers call for clinicians to screen for, identify, and treat this modifiable CVD risk factor. However, there is reluctance by many clinicians to initiate often-challenging clinical conversations. For researchers, identifying a robust methodology to collect sensitive data within this area can be difficult. One such methodology is factorial survey design, which incorporates variables of interest into clinical vignettes, which are then disseminated as a survey. Vignettes that replicate the realities of practice have been extensively authenticated through international studies and are particularly appropriate when exploring sensitive topics. This methods paper discusses implementing factorial design within an Internet-Mediated platform using an innovative and original approach of also embedding photographs within clinical vignettes. The recruitment of a large and complete, multiprofessional dataset (n = 427) indicated that clinicians engaged easily with the Internet Mediated platform and viewed virtual vignettes with integrated patient photographs as authentic, reflecting the complexities of clinical practice.