Obesity, Obesity and Obesity-related Medical Conditions, Obesity and Overweight, Obesity Prevention, Weight Management
Conditions
Keywords
Training, Implementation, Intensive Behavioral Treatment, Family-based Behavioral Treatment, Obesity, Obesity Care
Brief summary
This project will compare two training approaches for US Preventive Services Task Force recommended obesity care in Federally Qualified Health Centers (FQHC) across four aims. Aim 1 compares patient-level effectiveness \[i.e., patient relative weight change and the proportion of patients who achieve clinically significant weight loss\]. Aim 2 compares reach (patient treatment utilization). Aim 3 compares primary care provider (PCP) referrals to USPSTF-recommended care at 12 (adoption) and 24 months (maintenance) and short- and long-term changes in provider obesity care competencies . Aim 4 compares implementation and service costs.
Interventions
OTHERComprehensive Multidisciplinary Obesity Care
CMOC is an innovative approach to obesity care delivery that leverages policy, clinical and community linkages, and digital technology for scalability. CMOC involves training providers (medical providers, registered dietitians, and behavioral health providers) to deliver guideline-based obesity care for youth and adults with obesity who receive Medicaid. Guidelines-based care involves screening, identification, weight counseling, and referral to intensive behavioral treatment by medical providers, and delivery of multicomponent intensive behavioral treatment by behavioral health providers and registered dietitians.
OTHERImplementation as Usual Control
The standard of care implemented in FQHCs in the absence of CMOC training.
Sponsors
Washington University School of Medicine
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Children's Mercy Hospital Kansas City
University of Missouri-Columbia
Missouri Institute of Mental Health
University of Missouri, Kansas City
The Missouri Department of Social Services, MO HealthNet Division, Office of Transformation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Study Eligibility Criteria - Provider Trainees: * Provider Trainees must be PCPs, BHPs, RDNs, or CHWs who work at participating clinics. * PCPs that are eligible to participate as Provider Trainees can be any of the following: Medical Doctors (MD), Doctor of Osteopathic Medicine (DO), Physician Assistants (PA), or Nurse Practitioners (NP). PCPs must see patients in a primary care setting and be capable of referring patients to IBT and MNT. PCPs must have already completed their residency (when applicable). * BHPs that are eligible to participate as Provider Trainees must be at least one of the following categories (listed with typical credentials): Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Psychologist (PhD/PsyD), Psychiatric Nurse Practitioner, Psychiatrist (MD). * RDNs that are eligible to participate as Provider Trainees must be Registered Dietitians/Registered Dietitian Nutritionists. * CHWs must work as Community Health Workers, or in functionally similar role, within participating clinics Study Eligibility - EHR Patients: Benefit-Eligible Patients from Participating Clinics * Benefit-Eligible Patients from Participating Clinics can either be youth (ages 5-20) or adults (ages 21+) and must be recipients of Medicaid, eligible for the MO Medicaid benefit (i.e., Medicaid recipients with obesity), and have been seen at participating FQHC clinics.
Exclusion criteria
- Provider Trainees: * Not at a participating clinic * PCPs who do not have the ability to refer to IBT or MNT * Resident Doctors * A doctor specializing in reproductive health (or related fields)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in patient percent overweight | Months 2-29 post-enrollment | Percent over the median body mass index (BMI) for sex and age. |
Countries
United States
Contacts
CONTACTAubrie Hampp, MSc
CONTACTCorinne McMahon, MS, RDN, LD
PRINCIPAL_INVESTIGATORDenise Wilfley, Ph.D.
Washington University School of Medicine
Outcome results
None listed