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PATHWEIGH: pragmatic weight management in primary care

PATHWEIGH：初级保健中的实用体重管理

基本信息

批准号：
10681481
负责人：
JODI Summers HOLTROP
金额：
$ 61.63万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-17 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10681481
关键词：
Address Adopted Adoption Affect Body Weight decreased Clinic Clinical Data Cluster randomized trial Colorado Communities Complex Cost Analysis Data Data Analyses Data Collection Diagnosis Disease Education Effectiveness Epidemic Family Family Practice Family health status Glucose Health Insurance Carriers Internal Medicine Intervention Interview Life Style Mainstreaming Maintenance Mediator Medical Methods Modeling Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Overweight Patients Persons Pilot Projects Practical Robust Implementation and Sustainability Model Primary Care Process Provider Randomized Recommendation Recording of previous events Research Resources Risk Factors Site Smoking Surveys System Testing Time Training United States Universities Visit Weight Weight Gain Weight maintenance regimen Work comorbidity contextual factors cost effectiveness testing effectiveness/implementation hybrid electronic medical record system evidence base hybrid type 1 study implementation evaluation implementation strategy improved innovation multilevel analysis novel obesity management patient population practice setting preventable death primary care clinic service delivery standard of care success tool trial design

项目摘要

Project Summary/Abstract Obesity – with its many comorbid conditions – has now surpassed smoking as the leading cause of preventable death in the United States. Despite the fact that obesity is both treatable and preventable, treating the comorbidities, rather than obesity per se remains the mainstay of therapy. Importantly, obesity is being increasingly recognized not only as a risk factor for disease, but a disease unto itself. Despite this fact, <1% of people with any degree of overweight or obesity are offered anything other than lifestyle advice. Reasons for lack of weight management prioritization are extensive and complex. Effectively, the major stakeholders, including people with obesity, their clinicians and insurers, have yielded to the epidemic. Thus, there is a critical need to systematically address these diverse barriers with pragmatic approaches and evidence that facilitates the practice of weight management. To address this gap, the University of Colorado Health Family Medicine clinic in Westminster, Colorado developed PATHWEIGH. PATHWEIGH prioritizes weight management in primary care by: 1) using a designated, time-efficient flowsheet built into EPIC (the most widely utilized electronic medical record (EMR) system in the U.S.) that guides and captures history around weight gain and recommendations for weight loss, as well as practical issues related to diagnosis and billing, and 2) clinician and team training on a) use of PATHWEIGH as a tool, and b) education on current effective practices for weight management. Our pilot study demonstrated the ability to effectively implement PATHWEIGH in a primary care clinic that lead to significant improvement in patient weight loss over 18 months. The overall objective for the proposed work is to test the effectiveness of PATHWEIGH vs. standard of care in 57 primary care clinics that span diverse settings, patient populations and community contexts, as well as to examine methods to optimize implementation. Our specific aims include: 1) Evaluate the implementation of PATHWEIGH and determine its effectiveness versus control clinics using standard of care (SOC) on patient weight loss at 6 months (primary) and weight loss maintenance at 12 and 18 months (secondary) for weight- prioritized visits in primary care, 2) Identify predictors of patient weight loss and weight loss maintenance using mediator and moderator analysis, including relevant patient, provider and clinic-level variables, and 3) Examine contextual factors affecting the adoption, implementation and sustainability of PATHWEIGH using the Practical, Robust, Implementation and Sustainability Model (PRISM). To complete these aims, we will utilize a stepped wedge cluster randomized trial. Data collection and analysis methods include clinical data, surveys, observations and interviews using statistical, qualitative and mixed methods. PATHWEIGH has the potential to be a scalable, low-cost, pragmatic approach to obesity. The rationale that underlies the proposed research is that the ultimate success of PATHWEIGH relies on understanding how to implement evidence- based weight management interventions and make them most effective, used and maintained in practice.

项目总结/文摘

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Baseline Characteristics of PATHWEIGH: A Stepped-Wedge Cluster Randomized Study for Weight Management in Primary Care.

PATHWEIGH 的基线特征：初级保健体重管理的阶梯楔形聚类随机研究。

DOI：
10.1370/afm.2966
发表时间：
2023
期刊：
Annals of family medicine
影响因子：
4.4
作者：
Perreault,Leigh;Suresh,Krithika;Rodriguez,Carlos;Dickinson,LMiriam;Willems,Emileigh;Smith,PeterC;WilliamsJr,Johnny;Gritz,RMark;Holtrop,JodiSummers
通讯作者：
Holtrop,JodiSummers

An Assessment of Weight Loss Management in Health System Primary Care Practices.

DOI：
10.3122/jabfm.2022.220224r1
发表时间：
2023-02-08
期刊：
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
影响因子：
2.9
作者：
Suresh, Krithika;Willems, Emileigh;Williams, Johnny, II;Gritz, R. Mark;Dickinson, L. Miriam;Perreault, Leigh;Holtrop, Jodi Summers
通讯作者：
Holtrop, Jodi Summers

Prelude to PATHWEIGH: pragmatic weight management in primary care.

PATHWEIGH 的前奏：初级保健中的务实体重管理。

DOI：
10.1093/fampra/cmac092
发表时间：
2023
期刊：
Family practice
影响因子：
2.2
作者：
Wild,Jessica;Kaizer,Alexander;Willems,Emileigh;Kramer,ErikSeth;Perreault,Leigh
通讯作者：
Perreault,Leigh

A closer look at weight loss interventions in primary care: a systematic review and meta-analysis.

DOI：
10.3389/fmed.2023.1204849
发表时间：
2023
期刊：
FRONTIERS IN MEDICINE
影响因子：
3.9
作者：
Perreault, Leigh;Kramer, E. Seth;Smith, Peter C.;Schmidt, Darren;Argyropoulos, Christos
通讯作者：
Argyropoulos, Christos

PATHWEIGH, pragmatic weight management in adult patients in primary care in Colorado, USA: study protocol for a stepped wedge cluster randomized trial.