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Integrating online weight management with primary care support: patient-centered strategies for addressing overweight and obesity in primary care
Investigator (PI): Baer, Heather
Performing Organization (PO): (Current): Brigham and Women's Hospital, Department of Medicine / (617) 732-6340
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2015
Final Year: 2020
Record Source/Award ID: PCORI/IHS-1409-21758
Funding: Total Award Amount: $2,006,427
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: More than two-thirds of US adults are overweight or obese, which causes many health problems. Primary care doctors often lack sufficient time or training to counsel patients about weight loss, and there is a need for effective weight-management programs that are easy to use in the primary care setting. This study's goal is to identify successful, scalable strategies for weight management that could be offered to a broad group of primary care patients. This is important to patients because they care about their weight, are motivated to lose weight, and want more specific advice about weight management from their primary care doctors. Online weight management programs can help patients lose weight and are more convenient and accessible than are in-person programs, but few studies have examined whether they are effective in primary care settings. Population management is a new approach in which a primary care staff member reaches out to patients outside of office visits to help them address unmet health needs. Population management has improved care for such conditions as diabetes and hypertension, but it has not been used for weight management. We will adapt an existing online weight management program, based on feedback from patients and doctors, and use it with population management to help primary care patients with weight loss. A staff member at each primary care practice will be responsible for tracking patients' progress in the online program and for reaching out to them on a regular basis to provide support and to help them address problems or issues. We will compare three different strategies: (1) the online weight management program plus population management, (2) the online program alone, or (3) usual care. The main outcome that we will compare between the groups is weight loss over 12 months, but we also will compare changes in other outcomes, such as quality of life, cardiovascular risk factors, diet and physical activity, and confidence in ability to lose weight. These outcomes matter to patients and affect many aspects of their health and well-being. We also will assess patients' and doctors' satisfaction with the three strategies. The study will be conducted in 24 primary care clinics affiliated with Brigham and Women's Hospital. We will enroll patients between the ages of 20 and 70 who have an upcoming primary care visit, have a body mass index between 27 and 34.9 kg/m2, and have type 2 diabetes or hypertension. Patients will go to their primary care practices for regular visits and will complete surveys at several times during follow-up. Primary care doctors also will complete surveys. Patients and stakeholders will play a critical role in all aspects of this project. For example, they will be involved in testing and modifying the HealthTrac online program, developing the population management approach, drafting surveys, interpreting the results, and sharing the findings.
MeSH Terms:
  • Adult
  • Aged
  • Body Mass Index
  • Follow-Up Studies
  • Humans
  • Internet
  • Middle Aged
  • Obesity /*therapy
  • Outcome Assessment (Health Care)
  • Overweight /*therapy
  • Patient-Centered Care
  • Primary Health Care /*organization & administration
  • Program Development
  • Program Evaluation
  • Quality of Life
  • United States
  • Weight Reduction Programs
  • Young Adult
Country: United States
State: Massachusetts
Zip Code: 02115
UI: 20153583
CTgovId: NCT02656693
Project Status: Ongoing
Record History: ('2018: Project extended to 2020. 2017: Project extended to 2019.',)