DNP Graduate – Knoeckel

Sarah Knoeckel, DNP, APRN-BC

Improving Provider Identification and Management of Overweight and Obesity in Primary Care

Abstract

Background: Overweight and obesity are in epidemic proportions in the United States. This is alarming given that obesity is a risk factor for many secondary health conditions. Primary care providers (PCPs) are responsible for weight management interventions in clinical settings, yet obesity treatment guidelines are infrequently applied in practice. Purpose: The purpose of this study was to examine PCPs’ attitudes, beliefs, and behaviors as they relate to overweight and obesity guidelines in light of the Theory of Planned Behavior. Methods: A randomized controlled trial design was used. Participants included PCPs that care for adult patients employed at a federally qualified health center (FQHC) in the Northeast. Twenty-seven PCPs participated in the study. Data was gathered using an attitude and barrier questionnaire before and after the multifaceted intervention strategy. Performance data was also gathered using the electronic health records for documentation of overweight and obesity identification and management at baseline and monthly for five consecutive months. The multifaceted intervention strategy included an interactive educational workshop, educational outreach visits, and performance measurement and feedback of patient care data. Results: Results of the study for the questionnaire showed no significant change in responses from pre to post. Results for the performance showed an improvement in identification in the intervention group from pre (10%) to post (13%) (p<0.284), whereas the control group remained similar from pre (9%) to post (9.5%) (p=0.895). Results for the performance showed improvement in management in the intervention group from pre (10%) to post (15%) (p<0.01), whereas the control group remained similar from pre (5%) to post (7%) (p=0.273). Conclusion: Many FQHC PCPs do not routinely provide weight management treatment for obese patients. PCPs greatest reported barriers were lack of time during encounter, lack of motivation among patients and lack of ancillary resources. The multifaceted intervention strategy used was found to be effective at improving obesity management.