None listed
Conditions
Brief summary
This study tests an intervention to improve overweight patients' health literacy for weight loss and assist them to attend community-based weight management lifestyle modification programs. Study hypotheses: 1. Compared to practice nurses in control practices, those in intervention practices will demonstrate greater improvement in their self-reported behaviour and confidence in assessing obese patients with low health literacy and providing advice and referral to them for weight loss. 2. Compared to similar patients attending control practices, obese patients with low health literacy attending intervention practices are, at six months, more likely to report: *having received assessment, advice and referral for weight management *having attended/used community-based weight management lifestyle modification programs referred to. 3. Compared to similar patients attending control practices, obese patients with low health literacy attending intervention practices are, at 12 months, more likely to have improved their health literacy related to weight management.
Interventions
One practice nurse in each intervention practice will be trained as Prevention Navigator to assist patients to attend community-based referral programs and services.
The practice level intervention involves:
1.One clinical audit report and face to face 1.5-hour long meeting with general practitioners (GPs) and Prevention Navigators in own practices to identify priorities and strategies for improvement in the assessment and management of obese patients;
2. One 3-hour long training session (for
One practice nurse in each intervention practice will be trained as Prevention Navigator to assist patients to attend community-based referral programs and services. The practice level intervention involves: 1.One clinical audit report and face to face 1.5-hour long meeting with general practitioners (GPs) and Prevention Navigators in own practices to identify priorities and strategies for improvement in the assessment and management of obese patients; 2. One 3-hour long training session (for GPs and PNs including the Prevention Navigators) which will cover management of obese patients across the 5As of the chronic disease model approach – Assess, Advise,Agree, Assist and Arrange. 3. Prevention Navigators will be trained the concept of care navigation and their role in this. 4. Results from the health literacy screening are discussed at one 1.5-hour long meeting involving GPs and Prevention Navigators in own practices. The clinical level intervention involves: 1. Patients in the waiting room will be screened for low health literacy (using three validated questions translated into several languages). Those that are eligible and consent are invited to attend a Health Check visit with the Prevention Navigators. 2. At the Health Check visit, which will be approximately 30 minutes long,the patient will receive brief advice, set goals related to weight loss, be referred to community-based services or programs and makes a follow up appointment with the GP or Prevention Navigator. The intervention will be provided over a period of 6 months.
Sponsors
Professor Mark Harris
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
*Visited a participating GP at least once in the last 12 month *BMI >=30 *Can complete the health literacy screening questionnaire in English or one of the languages the questionnaire has been translated into *Identified with low health literacy: the combined score of the three health literacy questions is >10 or if the score is <=10, the score of question C alone is >=3 *Patient willing to return for a Health Check with the Prevention Navigator *Does not have any exclusion criterion
Exclusion criteria
*Heart disease *Stroke *Insulin-treated diabetes *Chronic renal impairment (eGFR < 60 mls/minute/1.73m2) *Previous bariatric surgery *Bariatric surgery planned in the next 12 months *Treated with orlistat or phentermine.
Outcome results
None listed