Online Counseling to Enable Lifestyle-focused Obesity Treatment in Primary Care
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 21 - 75 |
| Updated: | 4/21/2016 |
| Start Date: | April 2010 |
| End Date: | September 2012 |
With over half of the US population currently overweight and 31% of adults now obese, the
primary care setting may represent an important source of weight-loss support, in the
interest of cardiovascular prevention. Yet, although the US Preventive Services task force
recommends that physicians screen all adult patients for obesity and offer intensive
counseling and behavioral interventions to promote sustained weight loss for obese adults,
the recommendation has not been widely implemented. The Internet may help overcome many of
the barriers that have prevented intensive obesity counseling in the clinical setting. The
aim of this study is to examine whether Internet-based interventions for developing
healthier lifestyles can improve preventive health care in a cost-effective manner.
primary care setting may represent an important source of weight-loss support, in the
interest of cardiovascular prevention. Yet, although the US Preventive Services task force
recommends that physicians screen all adult patients for obesity and offer intensive
counseling and behavioral interventions to promote sustained weight loss for obese adults,
the recommendation has not been widely implemented. The Internet may help overcome many of
the barriers that have prevented intensive obesity counseling in the clinical setting. The
aim of this study is to examine whether Internet-based interventions for developing
healthier lifestyles can improve preventive health care in a cost-effective manner.
The study, Online counseling to enable lifestyle-focused obesity treatment in primary care,
aims to translate an evidence-based lifestyle intervention into the primary care setting,
using information technology to enable clinical lifestyle counseling. While the US
Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients
for obesity and offer intensive counseling and behavioral interventions to promote sustained
weight loss for obese adults, multiple barriers to intensive lifestyle counseling exist and
the recommendation has not been widely implemented. By requiring physician referral,
augmenting the health care team's access to behavioral expertise, and encouraging physician
feedback to participating patients, we aim to integrate lifestyle issues into routine
preventive medicine. We will examine change in weight, waist circumference, physical
activity, quality of life, and will calculate intervention cost-effectiveness. We will
ensure sustainability by using recruitment and adherence strategies that can be replicated
in routine practice, and counseling staff who are representative of the educators employed
in primary care practice. If an online strategy is effective, the extensive network of the
University of Pittsburgh Medical Center Health System provides excellent infrastructure for
supporting dissemination in the region. As such, this study may facilitate wide-spread
adoption of current evidence-based preventive medicine guidelines recommending incorporation
of intensive lifestyle interventions into primary care practice.
aims to translate an evidence-based lifestyle intervention into the primary care setting,
using information technology to enable clinical lifestyle counseling. While the US
Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients
for obesity and offer intensive counseling and behavioral interventions to promote sustained
weight loss for obese adults, multiple barriers to intensive lifestyle counseling exist and
the recommendation has not been widely implemented. By requiring physician referral,
augmenting the health care team's access to behavioral expertise, and encouraging physician
feedback to participating patients, we aim to integrate lifestyle issues into routine
preventive medicine. We will examine change in weight, waist circumference, physical
activity, quality of life, and will calculate intervention cost-effectiveness. We will
ensure sustainability by using recruitment and adherence strategies that can be replicated
in routine practice, and counseling staff who are representative of the educators employed
in primary care practice. If an online strategy is effective, the extensive network of the
University of Pittsburgh Medical Center Health System provides excellent infrastructure for
supporting dissemination in the region. As such, this study may facilitate wide-spread
adoption of current evidence-based preventive medicine guidelines recommending incorporation
of intensive lifestyle interventions into primary care practice.
Inclusion Criteria:
- Obese (BMI > 30kg/meters squared)
- Age 21-75
- Receives primary care at a participating primary care clinic in the Pittsburgh, PA
area
Exclusion Criteria:
- Primary care physician determination that moderate physical activity is not safe or
appropriate for the patient
- Pregnancy
- Planned pregnancy in the next 2 years
- Current breast-feeding
- Bariatric surgery in the past 2 years
- Planned bariatric surgery in the next 2 years
- Edematous state that interferes with body weight assessment
- Health condition that is likely to influence body weight
- Heart attack within the past 3 months
- Regular use of prescription medication that is likely to influence body weight
- participation during the past year in either of the pilot programs for this study
- perceived lack of basic computer or Internet skills
- Inability to learn adequately from English language audio-recorded materials
- Lack of access to a scale
- Inability to attend an Orientation session
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