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Culturally sensitive, primary care clinic-based interventions by community health workers and trained physicians to promote and sustain weight loss among black women patients with obesity
Investigator (PI): Tucker, Carolyn M
Performing Organization (PO): (Current): University of Florida, College of Liberal Arts and Sciences, Department of Psychology / (352) 392-0601
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2018
Final Year: 2022
Record Source/Award ID: PCORI/AD-1609-36187
Funding: Total Award Amount: $2,099,917
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Black women have the highest prevalence of obesity in the U.S. More than half (56.6%) of black women have obesity. This disease increases the likelihood of having diabetes and other chronic diseases, and decreases quality of life and life expectancy. The U.S. Preventive Services Task Force recommends that all adults who have obesity participate in an evidence-based, intensive, multicomponent behavioral treatment for this disease. Such treatment has been shown to produce clinically significant weight loss among patients; however, this weight loss is typically not sustained over time. Patients at the primary care clinics in our pilot study and health care professionals nationally agree that treatment of obesity should be occurring and evaluated in primary care settings. A major research gap is the lack of evidence that the treatment for obesity recommended by the Task Force is effective within primary care settings and with black women patients at these settings. Another research gap is the lack of research to identify an effective role for physicians in treating obesity given their busy schedules. A third research gap is the absence of research to identify an effective way of integrating community health workers (CHWs) into primary care settings to assist physicians and other providers with health promotion/care such as obesity treatment. The proposed study addresses these research gaps and the views of patients in our pilot study that they wanted culturally sensitive obesity treatments that produce and sustain weight loss and include having their providers talk with them about their weight in culturally sensitive/respectful ways. We will test the effectiveness of a culturally sensitive, evidence-based, intense, multi-component, behavioral program for treating obesity called Health SmartTM when this program is (a) implemented for 6 months in 20 primary care clinics by health care team integrated CHWs with black women patients who have obesity and (b) followed by either of two physician implemented behavioral counseling programs to prevent weight gain that are implemented quarterly over 12 months. Specifically, we will compare the effects on weight loss and weight loss maintenance of (1) Health Smart plus the Patient-centered Culturally Sensitive Weight Loss Maintenance Program and (2) Health Smart plus the Standard Behavioral Weight Loss Maintenance Program. We expect that (a) the first of these programs will result in significantly greater weight loss and weight loss maintenance and (b) that the model used to integrate CHWs into the health care team at each clinic will result in high ratings of this integration by the CHWs and other clinic staff involved with this study. This study is important to black women patients because it tests an obesity treatment of interest to such patients. Patients and other stakeholder partners will be involved in planning and implementing the study and in analyzing and disseminating study results.
MeSH Terms:
  • African Americans
  • Behavior Therapy
  • Chronic Disease
  • Community Health Services /*organization & administration
  • * Community Health Workers
  • Cultural Characteristics
  • Evidence-Based Medicine
  • Female
  • Health Behavior
  • Humans
  • Obesity /*ethnology
  • /psychology /*rehabilitation /therapy
  • Patient-Centered Care
  • Physicians
  • Pilot Projects
  • Preventive Medicine /methods
  • Primary Health Care /*organization & administration
  • Quality of Life
  • United States
  • Weight Loss
  • Weight Reduction Programs
Country: United States
State: Florida
Zip Code: 32611
UI: 20181367
Project Status: Ongoing
Record History: ('2018: Project extended to 2022.',)