Medicine and Health Sciences Commons^™

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve

Family Medicine Clerkship Student Projects

Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.

Primary Care Physician Supply And Population Health Outcomes In Florida, 2010-2019, Maxwell E. Droznin, Julia Fashner

HCA Healthcare Journal of Medicine

Background

Primary care physicians play vital roles in the prevention and management of chronic disease. With increasing rates of chronic disease and a national primary care physician shortage, the role that primary care physician supply has on health outcomes in Florida is not well understood. The objective of this study was to investigate the relationship between primary care physician supply (PCPS) and population health outcomes of obesity, life expectancy, coronary artery disease hospitalization, and death rate as reported by county in the state of Florida for the years 2010, 2013, 2016, and 2019.

Methods

This was a retrospective, cross-sectional study. …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

The Effect Of Perceived Weight Status And Bmi On Food Attitudes And Food Relationships, Sahil Patel, Ryan Gericke, Jaime Dougherty, Adarsh Gupta

Rowan-Virtua Research Day

The findings of this study have shed light on the intricate relationship that exists between perceived weight status from a “non-obese/obese” perspective and attitudes towards food and the overconsumption of particular food items. Participants who perceived their weight status as “obese” despite having a calculated BMI below the CDC threshold and classification for “obesity” had poorer relationships with food, consumption behaviors, and on average consumed food items that were detrimental to overall health. Comprehending a patient’s weight status perception and conducting a thorough history of their food intake could play a crucial role in addressing the patient’s overall health and …

A Multimodal Smartphone Application Intervention To Achieve Target Weight Goals In Overweight Adult Diabetics, Michael Thomas Schwuchow

Evidence-Based Practice Project Reports

Obesity is the leading risk factor for developing type 2 diabetes mellitus (American Diabetes Association, 2022). Diabetes mellitus (DM) and obesity put individuals at higher risk for developing heart disease, stroke, and hypertension, therefore, it is essential to properly manage both conditions. The purpose of this project is to determine if the implementation of an evidence-based weight loss intervention, MyFitnessPal© will result in reduction in body mass index (BMI) and lower hemoglobin A1c (HbA1c) levels in overweight adults with DM. A comprehensive literature search of six databases, hand searching, and citation chasing yielded 13 pieces of moderate to high quality …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Integrating Semaglutide Into Obesity Management - A Primary Care Perspective, Janine V. Kyrillos, Neil S. Skolnik, Bhasha Mukhopadhyay, Nicholas Pennings

Jefferson Hospital Staff Papers and Presentations

This final article in the supplement aims to summarize a clinical approach for weight management geared toward primary care practitioners, offering practical advice about how to integrate weight management into day-to-day practice. To achieve long-term successful weight loss, a comprehensive multimodal approach is recommended, focusing on both lifestyle modification and appropriate use of therapy. Once-weekly subcutaneous semaglutide 2.4 mg is a novel treatment that can be used as an adjunct to lifestyle modification for the management of overweight and obesity. Key considerations are presented to support its optimal administration in conjunction with lifestyle modification, with a focus on assessing suitability …

Weighty Words: Addressing Weight Bias In Primary Care, Jharna Jahnavi

Family Medicine Clerkship Student Projects

Weight bias in healthcare impacts a great proportion of patients. ­In some ways, weight bias often goes unaddressed compared to other forms of discrimination and spans across diverse groups of people resulting a double burden of bias in patients with intersecting marginalized identities. It is essential that providers and healthcare workers are better trained in building inclusivity for patients of all weights and body types to improve healthcare access and acceptance. Patients who experience weight bias in the office are less likely to return for routine preventative care and less likely to feel safe and comfortable with their providers. This …

A Healthier Diet For Weight Loss, Hannah White

Family Medicine Clerkship Student Projects

Many patients presenting to clinic have the goal of weight loss to improve their health as obesity has many comorbidities. Many patients have multiple health concerns like Diabetes Mellitus, Hypertension, Hyperlipidemia, PCOS, or joint pain. Part of the management of their conditions include weight loss, but many patients struggle, for years, to lose weight. A referral to the Metabolic Weight Loss clinic in Newtown, which will provide patients with nutritional information, evidence based diets, medications, exercises, and more, can take up to 1 year to get an appointment. The goal of this project is to provide information to patients in …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith

Evidence-Based Practice Project Reports

Obesity is a worsening pandemic that requires immediate action. It is recommended that primary care providers screen patients for obesity and provide multimodal behavioral interventions to their patients to treat and prevent obesity (USPSTF, 2018). The purpose of this evidenced-base practice (EBP) project is to implement a multimodal intervention for weight loss in adults within primary care. Five search engines were utilized, and 16 articles were ultimately selected as evidence. The evidence supported self-monitoring and close follow-up while in active weight loss. The Iowa Model for EBP to promote quality care was used as the framework to guide the project …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Improving Nutrition Literacy In Primary Care, Kami D. Dykes

DNP Research Projects

Abstract

By the year 2030, nearly one in every two adults will have obesity (Body Mass Index [BMI] ≥30 kg/m².), and one in four adults will have severe obesity (BMI ≥35 kg/m²) (Ward et al., 2019). Equally troubling is that obesity poses a threat to the health of individuals, decreases the quality of life, shortens life expectancy, causes and worsens comorbidities, and increases all- cause mortality (Abdelaal et al., 2017). Studies have shown a link between BMI, nutritional knowledge, and dietary practices. Nutrition literacy is a newer term that refers to the complex relationship between nutrition …

Tackling Access To A Healthier Life, Edom Alemayehu Girma

Family Medicine Clerkship Student Projects

Obesity is a known risk factor for complications during childhood and later in adult life. While numerous factors play a role in the prevalence of obesity, this project focused on better intervention for obesity management in the family medicine clinic located in Plattsburgh, NY. Interviews and literature searches were conducted to determine possible strategies to better assist patients in attaining their sustainable weight loss goals and an overall healthier lifestyle.

Home Exercise For Patients With Limited Access And Resources, Justin L. Esteban

Family Medicine Clerkship Student Projects

Patients with limited resources and who are socioeconomically disadvantaged, don’t have the time or resources available to partake/pursue exercise. Having a home workout program may prove to be beneficial to patients who don't have access to a gym, equipment, or are otherwise constrained by time.

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Missed Opportunities: Documentation And Referral Rates Among Children And Adults With Obesity, Heidi Walls, Christina Holt, Amy Haskins Phd, Williams Dexter

Journal of Maine Medical Center

Introduction: Our study reports rates of obesity documentation on the problem list (PL) and numbers of referrals to obesity medicine specialists and dietitians among pediatric and adult patients with obesity.

Methods: All pediatric and adult patients with obesity seen at 14 primary care clinics between 7/1/2017 and 6/30/2019 were evaluated for inclusion of obesity on the PL and referrals to obesity medicine specialists or dietitians.

Results: For children with BMI >95% for age, obesity was documented in 31.2%, and 12.5% received a referral. For adults with BMI >30, obesity was documented in 54.2%, and 8.4% received a referral. Significantly more …

Pharmaceutical Management Of Weight Loss, Jake Schutzman, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Briefly review some context & consequences of the US obesity epidemic
• Review available prescription anti-obesity medications
• Discuss details specific to each of these medications
• Review other medications affecting weight

After this lecture, I hope you will:

• Have a greater understanding of available anti-obesity medications
• Be more comfortable in patient discussions & management of obesity

Loneliness In Primary Care Patients: Relationships With Body Mass Index And Health Care Utilization, Tamara K. Oser, Siddhartha Roy, Jessica Parascando, Rebecca Mullen, Julie Radico, Alexis Reedy-Cooper, Jennifer Moss

Journal of Patient-Centered Research and Reviews

Purpose: Rates of loneliness and obesity have increased in recent decades. Loneliness and obesity independently have been found to be risk factors for negative physical and mental health outcomes. This study examined the rates and interrelationships of loneliness, body mass index (BMI), and health care utilization in a primary care setting.

Methods: A cross-sectional survey of adult patients presenting for outpatient care at 7 family medicine clinical practices in Pennsylvania was conducted. Survey questions included self-reported measures of loneliness, height/weight, number of health care visits, and potential confounders (eg, sociodemographic variables, health status). Bivariate and multivariable linear regression models were …

Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson

Evidence-Based Practice Project Reports

The United States (U.S.) is amidst an obesity epidemic, with Indiana ranking as the 15th worst state (Institute of Medicine, 2012; United Health Foundations, 2020). Despite current management strategies, the obesity rate in both the U.S. and Indiana continues to rise (WHO, 2020). Therefore, obesity management must change. The purpose of this evidence-based practice (EBP) project was to determine if the addition of shared medical appointments (SMAs) consisting of informational group sessions by specialists and brief individualized meetings with the provider will result in greater reduction of weight and body mass index (BMI) compared to standard care alone in those …

A Weight-Loss Intervention Augmented By A Wearable Device In Rural Older Adults With Obesity: A Feasibility Study, John A. Batsis, Curtis L. Petersen, Matthew L. Clark, Summer B. Cook, Francisco Lopez-Jimenez, Rima I. Al-Nimer, Dawna Pidgeon, David Kotz, Todd A. Mackenzie, Stephen J. Bartels

Dartmouth Scholarship

Background

Older persons with obesity aged 65+ residing in rural areas have reduced access to weight management programs due to geographic isolation. The ability to integrate technology into health promotion interventions shows a potential to reach this underserved population. Methods

A 12-week pilot in 28 older rural adults with obesity (body mass index [BMI] ≥ 30 kg/m2) was conducted at a community aging center. The intervention consisted of individualized, weekly dietitian visits focusing on behavior therapy and caloric restriction with twice weekly physical therapist-led group strengthening training classes in a community-based aging center. All participants were provided a Fitbit Flex …

Feasibility And Acceptability Of A Technology-Based, Rural Weight Management Int Ervention In Older Adults With Obesity, John A. Batsis, Curtis L. Petersen, Matthew M. Clark, Summer B. Cook, David Kotz, Tyler L. Gooding, Meredith N. Roderka, Rima I. Al-Nimer, Dawna M. Pidgeon, Ann Haedrich, K. C. Wright, Christina Aquila, Todd A. Mackenzie

Dartmouth Scholarship

Background

Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology.

Methods

A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m2. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing …

Effectiveness Of Behavior-Based Counseling For Weight Loss Maintenance: A Systematic Literature Review, Jaime V. Stanczyk

All Graduate Theses, Dissertations, and Other Capstone Projects

Obesity is linked to the development of chronic health conditions such as diabetes, hypertension, and atherosclerotic cardiovascular disease (ASCVD) at an annual expense of $147 billion in related healthcare costs. Effective lifestyle modification treatment for long-term WLM remains elusive. Traditional advice from primary care providers regarding dietary modification and increased physical activity has not led to WLM as a long-term outcome. Newer guidelines for the treatment of obesity now recommend high-intensity behavior-based counseling (BBC) programs that deliver traditional weight loss education in tandem with behavior-change strategies. Methods: A database search was conducted for peer reviewed literature published in 2012-2020 on …

Words Without Weight, Lucy Merriam

Family Medicine Clerkship Student Projects

BMI and weight loss are frequently recommended to patients but how weight is talked about with patients can have a negative effect on how they look at their bodies and health. The purpose of this project was to describe ways to discuss health with patients in a body positive way.

Family Medicine Community Project, Daniel Castro

Family Medicine Clerkship Student Projects

The goal of this project is to improve diet and nutrition literacy in the community. Though Vermont ranks low in the US in terms of obesity, it is still estimated the 60% of Vermonters are either overweight or obese. This represents an area of need in terms of improving diet and nutrition education to combat obesity, the health issues it produces, and the subsequent strain on the medical system

Dietary Health Screening, Luke Hallgarth

Family Medicine Clerkship Student Projects

Dietary recall by patients is time consuming & inefficient. This project aims to develop a screening tool to accurately and efficiently track patient's diets over the course of multiple healthcare visits.

Nutritional Habits: Encouraging Simplicity And Consistency, Alim Esemenli

Family Medicine Clerkship Student Projects

Nutrition plays a crucial role in development of diseases that are the leading causes of morbidity and mortality in the Unites States. However, due to reasons such as time limitations, lack of clear guidelines, and what seems like a sense of hopelessness felt by providers and patients alike upon lack of results, discussions around nutrition may lack in frequency, consistency, and/or adequacy of duration, Research shows that flexibility of mindset, as well as achievability and sustainability of nutritional goals, play a key role in achieving success in weight This project proposes a three-page document that can potentially help primary care …

Smoking Cessation Associated Weight Gain: The Role Of Diet And Exercise Counseling In Quitting Smoking, Benjamin D. Kagan

Family Medicine Clerkship Student Projects

Weight gain is a common unintended consequence of quitting smoking due to a combination of physiologic and behavioral factors. Counseling focused on diet and exercise reduces weight gain associated with smoking cessation. Reduction of weight gain related to smoking cessation maximizes the health benefit of quitting tobacco.

Challenges With Diet During The Covid Pandemic, Cinduja Nathan

Family Medicine Clerkship Student Projects

The ongoing COVID-19 pandemic has had a tremendous impact on many individual's lives and their families. It has caused many people to change their lifestyles and daily routines. This project focuses on how diet has changed during the COVID pandemic and explores the reasons for these diet changes. 23 patients from the Central Vermont Medical Center were given surveys and their responses were analyzed and recorded. Out of the 23 patients, 20 patients reported that they noticed a change in their diet as a result of COVID 19. Of the 20 patients who noticed a change in their diet, 5 …

Waist Circumference As A Vital Sign, Brad R. Fiske

Family Medicine Clerkship Student Projects

Conversion of research protocol into QI project at Norwalk Community Health Center. Goal is to implement waist circumference as a vital sign.