Primary Care Commons^™

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 …

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 …

Adipose Tissue As Pain Generator In The Lower Back And Lower Extremity: Application In Musculoskeletal Medicine, Se Won Lee, Craig Van Dien, Sun Jae Won

HCA Healthcare Journal of Medicine

Adipose tissue (AT) has diverse and important functions in body insulation, mechanical protection, energy metabolism and the endocrine system. Despite its relative abundance in the human body, the clinical significance of AT in musculoskeletal (MSK) medicine, particularly its role in painful MSK conditions, is under-recognized. Pain associated with AT can be divided into intrinsic (AT as a primary pain generator), extrinsic (AT as a secondary pain generator) or mixed origin. Understanding AT as an MSK pain generator, both by mechanism and its specific role in pain generation by body region, enhances the clinical decision-making process and guides therapeutic strategies in …

Increasing Patient Enrollment In The Move Program At The Va Medical Center: An Evidence-Based Practice Project, Mandy Spiers

Student Scholarly Projects

Practice Problem: This evidence-based practice project aimed to increase patient referrals to the MOVE program by educating providers about the importance and benefit of the Managing Obesity for Veterans Everywhere (MOVE) Program at the Biloxi, Veterans Affairs (VA) Medical Center.

PICOT: In obese, ambulatory care patients, what motivates increased referrals by practitioners to the MOVE Program to decrease BMI compared to the current referral system within two months?

Evidence: There was poor participation in the MOVE Program despite the high number of obese patients at the Biloxi, VA Medical Center. According to the data, only sixty of the 18,000 …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

A Multicomponent Tailored Intervention Program Protocol For Weight Loss In An Underserved Adult Patient Population With Obesity, Rita R. Arnold

Evidence-Based Practice Project Reports

Obesity is a multifactorial, individualized, chronic disease that increases known risk factors for significant comorbidities and mortality. The primary purpose of this Evidence-Based practice project was to improve indicators of obesity (weight, BMI) among patients served by a free medical clinic, using a tailored multicomponent intervention. The secondary purpose was to determine if the weight loss intervention was associated with a decrease in blood pressure and depression symptoms. The intervention was guided by the Health Promotion Model by Nola Pender. The Johns Hopkins Nursing Evidence Based Practice Model (JHNEBP) guided implementation of the project. A comprehensive literature review was completed …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

The Effect Of Physician Held Stigmas And Bias On The Health Outcomes Of Patients With Obesity: A Review Of The Literature, Rachel Cohen, Catherine Jones

Journal of Health Disparities Research and Practice

Obesity is a growing epidemic that continues to garner attention throughout healthcare. The goal of this study was to review the literature on physician bias and stigmas surrounding obesity to assess the current state of research on connections between obesity-related stigma and the health outcomes and care of patients with obesity. A specific search string was used to obtain articles via PubMed and psychINFO, yielding 14 studies found that investigate these connections. The studies were categorized into three distinct pathways leading from physician stigma and biases to differing health outcomes of patients with obesity. These three pathways- perceptions, patient interaction, …

Using Physician Champions To Extend The Reach Of The Let’S Go! 5-2-1-0 Obesity Prevention Program In Clinical Practice, Michael Dedekian, Jackie Vine, Jonathan Fanburg, Naomi Anderson Schucker, Victoria Rogers

Journal of Maine Medical Center

ABSTRACT

Introduction: There is limited evidence for large scale interventions to address childhood obesity. Let’s Go! is a Maine-based obesity prevention program that deploys a consistent message across multiple community settings to encourage children and families to make healthy choices. This report describes implementation of Let's Go! in primary care offices.

Methods: Consideration for physician champion recruitment included previous involvement with Let’s Go! and ensuring statewide geographic coverage. Champions received standardized training and became local leaders in obesity prevention and treatment. 13 champions engaged 99 practices at baseline; 71 practices were engaged all 4 years (2012-2015). Data were analyzed on …

Nutrition Education For The Underserved Youth Within The Greater Twin Cities Area Through The Insports Foundation, Paige D. Deters, Allison Kaper, Maura Romanshek

All Electronic Theses and Dissertations

It has been examined that poor access to nutritious foods and limited opportunities for physical activity is prevalent among children from underserved families. These deficiencies contribute to increasing childhood obesity rates and emphasize the need for early interventions. Establishing nutritional literacy and understanding the importance of an active lifestyle in early childhood can lead to long-term health benefits and reduction in chronic disease later in life (HHS & USDA, 2015; Tsai et al., 2011; Wang et al., 2011). The InSports Foundation serves as a comprehensive non-profit organization that addresses many of these issues by providing children from underserved families with …

Patient Barriers For Weight Management Among African American Women, Owen Bowie, Jennifer Kusch, George L. Morris Iii, Tracy Flood, Jessica Gill, Renee E. Walker, Ron A. Cisler, Jennifer T. Fink

Journal of Patient-Centered Research and Reviews

Purpose: The primary aim of this study was to assess the perceptions of local African American women who are overweight or obese using semi-structured focus groups to identify barriers to weight management and factors that support strategy success. The secondary aim of this study was to determine recommendations for patient-centered weight management interventions established specifically for African American women in the Milwaukee-area community.

Methods: Three semi-structured focus groups to explore barriers to weight management were performed among women patients. Participants (N = 41) were recruited via email, postal mail, and phone as available from an academic medical center in Milwaukee, …

Primary Care Physician Delivered Brief Behavioral Intervention For Adult Obesity And Associated Health Conditions, Julia C. Huston

Dissertations

Obesity is a chronic health condition with prevalence rates that have continued to rise steadily over the past 30 years to the point that it has now been declared a global epidemic and a serious public health concern. Obesity is associated with significant physical and economic costs, primarily resulting from co-occurring health conditions that increase the risk of morbidity including type II diabetes, hypertension, dyslipidemia, stroke, coronary heart disease, and respiratory problems. Despite the dissemination of several obesity treatments, including pharmacotherapy, lifestyle modification, and bariatric surgery, the prevalence and severity of obesity continues to rise. Federal guidelines recommend the use …

Sensitivity Of Current Methods For Diagnosing And Documenting Metabolic Syndrome Within A Large Community-Based Health Care System, Tiffany A. Mullen, Danielle M. Greer, Jennifer T. Fink, Renee E. Walker

Journal of Patient-Centered Research and Reviews

Background: Metabolic syndrome (MetS) is a constellation of metabolic conditions, including abdominal obesity, high blood pressure, high triglyceride level, low high-density-lipoprotein level and high fasting blood glucose level, that increase the risk of developing chronic health conditions. Various combinations of diagnostic criteria have been proposed, including those by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), World Health Organization (WHO) and International Diabetes Foundation (IDF), among others. However, inconsistent use of diagnostic criteria and inadequate scientific evidence supporting use of specific criteria are current problems in health care.

Purpose: Quantify the prevalence of MetS diagnosis within the …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Should Primary Care Physicians Address Sleep To Improve Weight Loss In Obese Patients? A Clin-Iq, Kjersti E. Knox

Journal of Patient-Centered Research and Reviews

Obesity is a commonly encountered problem in the primary care setting. Simultaneously, sleep is seen to hold an increasingly important role in many components of health and wellness. A review of the literature was performed to determine if improving sleep positively impacts weight loss in obese adults. The evidence reviewed suggests that improving patients’ sleep may initially improve patient weight loss; however, current studies do not show a sustained statistically significant impact. Until higher powered and higher quality studies are completed, there are no clear evidence-based guidelines for primary care physicians to follow regarding sleep and obesity.

The Association Of Primary Care Physician Supply To The Prevalence Of Diabetes, Obesity, Smoking, And Hypertension In Georgia, Dennis L. White

MUSC Theses and Dissertations

The primary focus of this study was to compare primary care physician supply throughout Georgia to the prevalence of diabetes, obesity, smoking, and hypertension county by county, identifying potential issues related to primary care physician supply. This research identified the distribution of the primary care physician workforce across Georgia; county by county, and in urban and rural areas, and across public health districts. Then, the research identifies whether the current supply of Georgia primary care physicians is sufficient to meet the growing need for population healthcare. Studying the area of primary care physician supply in correlation to the prevalence of …