scholarly journals A web-based intervention to increase weight loss treatment initiation: results of a cluster randomized feasibility and acceptability trial

2019 ◽  
Author(s):  
Megan A McVay ◽  
William S Yancy ◽  
Gary G Bennett ◽  
Erica Levine ◽  
Seung-Hye Jung ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Treatment Initiation ◽  
Primary Care Providers ◽  
Feasibility Trial ◽  
Care Providers ◽  
Behavioral Weight Loss ◽  
Weight Loss Treatment ◽  
Primary Care Patients ◽  
Cluster Randomized

Abstract Evidence-based behavioral weight loss treatment is under-utilized. To increase initiation of treatment, we developed a single-session, online, primary care-based intervention (“mobilization tool”). We evaluated the mobilization tool's acceptability for primary care patients with obesity, trial design feasibility, and signal of an effect of the tool on treatment initiation. In this cluster randomized feasibility trial, primary care providers (PCPs) were randomized to a mobilization tool or comparator tool arm. Patients with obesity and a scheduled appointment with a randomized PCP were assigned to complete the mobilization or comparator tool prior to their appointment. The online mobilization tool asks patients to answer questions about a variety of weight-related topics and then provides automated, tailored feedback that addresses psychosocial determinants of weight loss treatment initiation. The comparator tool provided a nontailored description of treatments. All participants were offered free enrollment in behavioral weight loss treatments. Six PCPs were randomized. Sixty patients (57% female; 66% white; aged 55 ± 13 years) participated in this study of 296 contacted for eligibility evaluation (20.2%). Six-month follow-up assessments were completed by 65% (22/34) of the mobilization and 73% (19/26) of comparator tool participants. Participants completing the acceptability survey reported that the mobilization tool was usable, enjoyable, informative, and useful. Weight loss treatment was initiated by 59% (n = 19) of mobilization and 33% (n = 8) of comparator tool participants. The mobilization tool shows promise for increasing treatment initiation among primary care patients, which may increase population weight loss. Trial Registration: Clinicaltrials.gov identifier: NCT02708121.

scholarly journals Primary Care Providers’ Perspectives on Online Weight-Loss Programs: A Big Wish List

2012 ◽  
Vol 14 (1) ◽  
pp. e16 ◽  
Author(s):  
Kevin O Hwang ◽  
Heather L Stuckey ◽  
Monica C Chen ◽  
Jennifer L Kraschnewski ◽  
Samuel N Forjuoh ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Providers ◽  
Care Providers ◽  
Weight Loss Programs

scholarly journals Effects of an Enhanced Training on Primary Care Providers Knowledge, Attitudes, Service and Skills of Dementia Detection: A Cluster Randomized Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaozhen Lv ◽  
Mei Zhao ◽  
Tao Li ◽  
Changzheng Yuan ◽  
Haifeng Zhang ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Training Group ◽  
Primary Care Providers ◽  
Online Support ◽  
Attitude Score ◽  
Care Providers ◽  
Standard Training ◽  
Cluster Randomized

Background: Effective training programs for primary care providers (PCPs) to support dementia detection are needed, especially in developing countries. This study aimed to investigate the effect of an enhanced training on the competency and service of PCPs for dementia detection.Methods: We conducted a cluster randomized trial in Beijing, China. Community healthcare centers (CHCs) located in Fengtai or Fangshan District were eligible. The enrolled CHCs in each district were randomly assigned to the standard or the enhanced training group at a 1:1 ratio. PCPs serving older adults in enrolled CHCs were eligible to participate. The standard training group received three-hour didactic lectures, three monthly supervisions, 3 months of online support and dementia screening packages. The enhanced training group additionally received three monthly face-to-face supervisions and 3 months of online support. The participants became aware of their group membership at the end of the standard training. The knowledge, attitudes, service, and skills regarding dementia detection were assessed using questionnaires and submitted dementia detection records, respectively.Results: A total of 23 and 21 CHCs were randomly assigned to the standard and the enhanced training group, respectively, and 58 participants from 20 CHCs assigned to the standard training group and 48 from 16 CHCs assigned to the enhanced training group were included in the final analysis (mean age 37.5 years, and 67.0% women). A significant increase in the knowledge score was found in both groups, but the increase was similar in the two groups (P = 0.262). The attitude score remained stable in both groups, and no between-group difference was found. Compared with the baseline, both groups reported an increase in dementia detection service, especially the enhanced training group (24.1% to 31.0% in the standard training group and 14.6% to 45.8% in the enhanced training group). The completion rate and accuracy of submitted dementia detection records in the enhanced training group were both significantly higher than those in the standard training group (both P < 0.001).Conclusion: The enhanced training had similar effect on the knowledge of PCPs comparing with the standard training, but was better on continuous service and skills of PCPs related to dementia detection.Trial registration:www.ClinicalTrials.gov, identifier: NCT02782000. Registration date: May 2016. The trial was completed in July 2017.

Who Participates in Internet-Based Self-Management Programs? A Study Among Novice Computer Users in a Primary Care Setting

2000 ◽  
Vol 26 (5) ◽  
pp. 806-811 ◽  
Author(s):  
Edward G. Fell ◽  
Russell E. Glasgow ◽  
Shawn Boles ◽  
H. Garth McKay
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Self Management ◽  
Management Support ◽  
Care Providers ◽  
Computer Ownership ◽  
Primary Care Patients ◽  
Status Information ◽  
Insulin Use

PURPOSE the purpose of this study was to evaluate the participation rates and factors associated with nonparticipation among primary care patients who were invited to join an Internet-based self-management research program. METHODS Primary care providers invited their patients with type 2 diabetes to participate in an Internet-based diabetes self-management support program. Research staff contacted these patients by phone to assess their eligibility and interest in participating. Reasons for declining were assessed and demographic/medical status information was collected. RESULTS Of the eligible patients, 60% participated in the program. No significant differences were found between participants and decliners in gender, insulin use, computer familiarity, or computer ownership. There were significant differences in age and years since diagnosis. Participants were slightly younger and had diabetes for a fewer number of years than nonparticipants. Nonparticipation was not related to computer or Internet issues. CONCLUSIONS Most older diabetes patients without previous Internet experience will-takepart in Internet-based self-managment support programs if barriers to participation are addressed.

scholarly journals Validation Study of a Predictive Algorithm to Evaluate Opioid Use Disorder in a Primary Care Setting

2017 ◽  
Vol 4 ◽  
pp. 233339281771741
Author(s):  
Maneesh Sharma ◽  
Chee Lee ◽  
Svetlana Kantorovich ◽  
Maria Tedtaotao ◽  
Gregory A. Smith ◽  
...  
Keyword(s):  
Primary Care ◽  
Validation Study ◽  
Primary Care Providers ◽  
Opioid Use Disorder ◽  
Public Health Issue ◽  
Care Providers ◽  
Opioid Use ◽  
Predictive Algorithm ◽  
Primary Care Patients ◽  
Treatment Changes

Background: Opioid abuse in chronic pain patients is a major public health issue. Primary care providers are frequently the first to prescribe opioids to patients suffering from pain, yet do not always have the time or resources to adequately evaluate the risk of opioid use disorder (OUD). Purpose: This study seeks to determine the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm (“profile”) incorporating phenotypic and, more uniquely, genotypic risk factors. Methods and Results: In a validation study with 452 participants diagnosed with OUD and 1237 controls, the algorithm successfully categorized patients at high and moderate risk of OUD with 91.8% sensitivity. Regardless of changes in the prevalence of OUD, sensitivity of the algorithm remained >90%. Conclusion: The algorithm correctly stratifies primary care patients into low-, moderate-, and high-risk categories to appropriately identify patients in need for additional guidance, monitoring, or treatment changes.

Promoting oral cancer examinations to medical primary care providers: a cluster randomized trial

2016 ◽  
Vol 76 (4) ◽  
pp. 340-349 ◽  
Author(s):  
Alvin G. Wee ◽  
Lani M. Zimmerman ◽  
James R. Anderson ◽  
Martha E. Nunn ◽  
Fausto R. Loberiza ◽  
...  
Keyword(s):  
Primary Care ◽  
Oral Cancer ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cluster Randomized ◽  
Oral Cancer Examinations

scholarly journals Survey of Perceptions and Educational Needs of Primary Care Providers Regarding Management of Patients with Class II and III Obesity in Ontario, Canada

2020 ◽  
Author(s):  
Boris Zevin ◽  
Mary Imelda Martin ◽  
Nancy Dalgarno ◽  
Linda Chan ◽  
Nardhana Sivapalan ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Providers ◽  
Class Ii ◽  
Care Providers ◽  
Long Term Follow Up ◽  
Additional Education ◽  
Weight Loss Interventions

Abstract Background: Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI).Methods: We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results: Surveys were distributed to 591 PCPs (n=538 family physicians; n=53 nurse practitioners) identified as practicing in the Southeastern Ontario and 103 (17.4%) participated. PCPs serving a rural population estimated that 14.2±10.9% of patients would qualify for MSWLI compared to 9.9±8.5% of patients of PCPs serving an urban population (p=.049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past five years. Conclusion: The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.

scholarly journals Promoting Collaborative Goal Setting for Cancer Prevention Among Primary Care Patients: Pilot Testing a New Application (Preprint)

2020 ◽  
Author(s):  
Daniel Resnick ◽  
Marilyn M. Schapira ◽  
Jazmine M. Smith ◽  
Allison Bautista ◽  
Chang Xu ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Prevention ◽  
Goal Setting ◽  
Behavioral Change ◽  
Mobile Application ◽  
Primary Care Providers ◽  
Care Providers ◽  
System Usability Scale ◽  
Primary Care Patients ◽  
The Mean

BACKGROUND Many newly diagnosed cancers are associated with modifiable lifestyle behaviors, such as diet, exercise, smoking cessation, and maintaining a healthy weight. Despite this, primary care providers rarely discuss cancer prevention behaviors with their patients. OBJECTIVE To assess the usability, acceptability and engagement of the Healthier Together mobile application, which is designed to promote cancer prevention behaviors among Non-Hispanic Black primary care patients, utilizing social network and goal setting theories of behavior change. METHODS In an eight-week pilot study, we enrolled primary care patients (n=41) and provided these participants with a cancer prevention mobile application that allowed them to select, track, and share progress on cancer prevention goals with other users. We assessed application usability with the System Usability Scale (SUS). We assessed app acceptability by qualitatively analyzing open-ended responses about participants’ overall experience with the app. We assessed participant engagement by analyzing the built-in data capture, including how many times participants checked in (out of a maximum of eight) during the study. RESULTS Of 41 participants, the mean age was 51 (SD: 12) and 31 (76%) were women. App use data was captured for all participants and 34 (83%) completed the exit survey and interview. The mean SUS score was 87 (SD ±12; median 90; IQR 78-95). Analysis of open-ended responses revealed several key themes, with participants complementing the application’s ease of use and health behavior promoting features, while also commenting on the need for more feedback and social interactions through the application. On average, participants checked in 5.7 times (SD: 2.7) out of eight possible opportunities. Thirty-one participants (76%) checked in during at least 4 of the 8 weeks. Secondary analyses revealed that participants often accomplished their set goal (mean: 5.1, SD: 2.7) for each week. Qualitative analysis of comments participants left within the app after each weekly check-in revealed several themes on how the app assisted participants in behavioral change, highlighting that some participants built up exercise programs, ate healthier foods, lost a significant amount of weight, and stopped smoking during the study. CONCLUSIONS The implementation of a mobile cancer prevention goal setting application in a primary care setting was feasible with high usability, acceptability, and engagement from participants. User feedback revealed an influence on health behaviors. These findings suggest the promise of the HT application to facilitate behavioral change to reduce cancer risk among Non-Hispanic Black primary care patients.

scholarly journals Clinical and Socioeconomic Predictors of Palliative Care Utilization

2021 ◽  
Author(s):  
Rohan Tummala ◽  
Andrew de Jesus ◽  
Natasha Tillett ◽  
Jeffrey Nelson ◽  
Christine Lamey
Keyword(s):  
Primary Care ◽  
Socioeconomic Status ◽  
Palliative Care ◽  
Primary Care Providers ◽  
Care Utilization ◽  
Care Providers ◽  
Lower Systolic Blood Pressure ◽  
Care Clinic ◽  
Hospital Referral ◽  
Primary Care Patients

INTRODUCTION: Palliative care continues to gain recognition among primary care providers, as patients suffering from chronic conditions may benefit from use of this growing service. OBJECTIVES: This single-institution quality improvement study investigates the clinical characteristics and socioeconomic status (SES) of palliative care patients and identifies predictors of palliative care utilization. METHODS: Retrospective chart review was used to compare clinical and SES parameters for three groups of patients: (1) palliative care patients who attended at least one visit since the inception of the University Clinical Health Palliative Care Clinic in Memphis, TN in October 2018 (n = 61), (2) palliative care patients who did not attend any appointments (n = 19), and (3) a randomized group of age-matched primary care patients seen by one provider from May 2018 to May 2019 (n = 36). A Poisson regression model with backward conditional variable selection was used to determine predictors of palliative care utilization. RESULTS: Patients across the three care groups did not differ in demographic parameters. Compared to palliative care-referred non-users and primary care patients, palliative care patients tended to have lower health risk (p < 0.001). Palliative care patients did not differ from primary care patients in socioeconomic status but did differ in comorbidity distribution, having a higher prevalence of cancer (𝜒2 = 14.648, df = 7, p = 0.041). Chance of 10-year survival did not differ across risk categories for palliative care patients but was significantly lower for very high-risk compared to moderate-risk primary care patients (30% vs. 78%, p = 0.019). Significant predictors of palliative care use and their corresponding incidence rate ratios (IRR) were hospital referral (IRR = 1.471; p = 0.039), higher number of prescribed medications (IRR = 1.045; p = 0.003), lower Charlson Comorbidity Index (IRR = 0.907; p = 0.003), and lower systolic blood pressure (IRR = 0.989; p = 0.004). CONCLUSIONS: Patients who are expected to benefit from and of being high utilizers of palliative care may experience greater clinical benefit from earlier referral to this service.

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