Open Access Open Access  Restricted Access Subscription Access

Provider Views of the Feasibility and Utility of Lifestyle Obesity Treatment in Primary Care: Insights from the Think Health! Study

Etienne Phipps, Lisa Chacko, Jennifer Fassbender, Kelly Allison, David Sarwer, Samantha Wallace, Susan Tan-Torres, Marjorie Bowman, Thomas Wadden, Shiriki Kumanyika

Abstract


Rationale:   Feasible approaches for providing obesity treatment in primary care settings have been difficult to identify. We assessed the views of primary care clinicians and practice staff about a simplified, lifestyle weight loss program after their participation in a randomized trial designed to evaluate the program within their clinical practices. 

Methods: Post-hoc interviews were conducted with 13 clinicians and 12 auxiliary staff at the 5 participating practices in the Think Health! Study of weight management in primary care.  A 13-item survey was used to guide semi-structured interviews about the perceived strengths, weakness, and potential long-term utility of the program. Responses were analyzed using descriptive statistics and qualitative methods.

Results:  Providers unanimously endorsed the need for weight loss counseling for their patients.  They supported the need for more frequent visits initially to best engage patients in a weight loss program.  Additional training in counseling skills was desired.

Conclusion:  Clinicians participating in a practice- based trial valued having weight loss materials available to share with patients.  Offering patient materials that convey key content and structure for behavior change tasks while allowing provider discretion in how materials are integrated into patient care might be a viable option for testing in future practice-based research. 


Full Text:

PDF

References


Leblanc, E.S., O'Connor, E., Whitlock, E.P., Patnode, C.D. & Kapka, T. (2011). Effectiveness of primary care-relevant treatments for obesity in adults: a systematic evidence review for the U.S. Preventive Services Task Force. Annals of Internal Medicine 155 (7) 434-447.

Kumanyika, S., Fassbender, J., Phipps, E., Tan-Torres, S., Localio, R., Morales, K.H., Sarwer, D.B., Harralson, T., Allison, K., Wesby, L., Kessler, R., Tsai, A.G. & Wadden, T.A. (2011). Design, recruitment and start up of a primary care weight loss trial targeting African American and Hispanic adults. Contemporary Clinical Trials 32 (2) 215-224.

Kumanyika, S.K., Fassbender, J.E., Sarwer, D.B., Phipps, E., Allison, K.C., Localio, R., Morales, K.H., Wesby, L., Harralson, T., Kessler, R., Tan-Torress, S., Han, X. & Tsai, A.G. (2012). One-year results of the Think Health! study of weight management in primary care practices. Obesity (Silver Spring) 20 (6) 1249-1257.

Kumanyika, S. (2010). Modeling Effective Approaches to Obesity Treatment in Primary Care. Final Report to the Commonwealth of Pennsylvania.

U.S. Preventive Services Task Force. (2003). Screening for obesity in adults: recommendations and rationale. Annals of Internal Medicine 139 (11) 930-932.

Diabetes Prevention Program Research Group. (2002). The Diabetes Prevention Program (DPP): description of lifestyle intervention Diabetes Care 25 (12) 2165-2171.

Tsai, A.G., Wadden, T.A., Rogers, M.A., Day, S.C., Moore, R.H. & Islam, B.J. (2010). A primary care intervention for weight loss: results of a randomized controlled pilot study. Obesity (Silver Spring)18 (8) 1614-1618.

Strauss, A.C. & Corbin, J. (1997). Grounded Theory in Practice. Thousand Oaks, CA: Sage.

Ryan, G. & Bernard, H. (2003). Techniques to identify themes in qualitative data. Field Methods 15 (1) 85-109.

Adelman, A.M. & Graybill, M. (2005). Integrating a health coach into primary care: reflections from the Penn state ambulatory research network. Annals of Family Medicine 3 (Supplement 2) S33-35.

Cohen, D.J., Tallia, A.F., Crabtree, B.F. & Young, D.M. (2005). Implementing health behavior change in primary care: lessons from prescription for health. Annals of Family Medicine 3 (Supplement 2) S12-19.

Centers for Medicare and Medicaid Services. Department of Health & Human Services. (2011). Decision Memo for Intensive Behavorial Therapy for Obesity, Baltimore 2011.




DOI: http://dx.doi.org/10.5750/ejpch.v3i1.878

Refbacks

  • There are currently no refbacks.