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The Louisiana trial to reduce obesity in primary care
Investigator (PI): Katzmarzyk, Peter T
Performing Organization (PO): (Current): Louisiana State University, Pennington Biomedical Research Center / (225) 763-2500
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2015
Final Year: 2020
Record Source/Award ID: PCORI/OB-1402-10977
Funding: Total Award Amount: $9,854,769
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Obesity is a very common and serious medical and social condition, with Louisiana currently ranked first among the states for the highest levels of obesity. Obesity is a condition that increases the risk of type 2 diabetes, heart disease, stroke, gallbladder disease, respiratory problems, quality of life, and several cancers. Obesity and its health problems greatly affect underserved populations, and Louisiana is characterized by high levels of poverty, low health literacy, and food insecurity, all of which may contribute to the high obesity levels in the state. While the high rates of obesity are of great concern, a greater concern is that our health care system has failed to deliver medical interventions capable of producing even modest weight loss. Recently, the American Heart Association, American College of Cardiology, and the Obesity Society released a set of treatment guidelines for obese patients which are adaptable to real-life settings and which could add effective methods for obesity treatment in the primary care setting. Based on this, we know that modest weight loss is achievable in some settings; however, there has been no successful translation of this achievement to primary care practices. Primary care physicians remain the cornerstone of medical care in the United States. Thus, the primary aim of this study is to test the effectiveness of a 24-month, patient-centered, pragmatic and scalable obesity treatment program delivered within primary care in an underserved population. We will randomly assign 14 primary care clinics serving low-income populations with a high percentage of African Americans throughout Louisiana to either a comprehensive obesity treatment program or to a usual care group that receives the current obesity treatment under Medicaid/Medicare. Patients and stakeholders will be engaged at all phases of the project. We will initiate and maintain the process of building trust among the community, investigators, and the primary care clinics by expanding existing, and fostering new, trusted relationships. The partnerships will seek the well-being of its people through research, education, and service. The four key aspects of community engagement and outreach, rooted in the community-based participatory research principles, will be 1) create community and patient awareness; 2) inform the community of the study's benefits; 3) involve patients and stakeholders as collaborators through active participation in the study; and 4) provide mechanisms to convey healthy weight information back to the community. This intervention is designed to be economical and scalable to large patient populations. Given the low uptake of the current Medicaid/Medicare reimbursement for obesity, it is anticipated that the results will impact the way that obesity treatment options are funded in the future. This study will have a direct impact on improving healthcare delivery and outcomes, which are key components of the PCORI mission.
MeSH Terms:
  • Community Health Services /organization & administration
  • Community-Based Participatory Research
  • Comparative Effectiveness Research
  • Health Care Costs
  • Humans
  • Louisiana
  • Medicaid
  • Medically Underserved Area
  • Medicare
  • Obesity /*rehabilitation
  • /*therapy
  • Outcome Assessment, Health Care
  • Patient-Centered Care
  • Primary Health Care /*organization & administration
  • Program Development
  • Program Evaluation
  • United States
Country: United States
State: Louisiana
Zip Code: 70808
UI: 20152327
CTgovId: NCT02561221
Project Status: Ongoing
Record History: ('2017: Project extended to 2020.',)