ORIGINAL RESEARCH
Krithika Suresh, PhD; Emileigh Willems, PhD; Johnny Williams II, MPH; R. Mark Gritz, PhD; L. Miriam Dickinson, PhD; Leigh Perreault, MD; Jodi Summers Holtrop, PhD, MCHES
Corresponding Author: Jodi Summers Holtrop, PhD, MCHES; University of Colorado Department of Family Medicine - University of Colorado Adult & Child Center for Outcomes Research & Delivery Science (ACCORDS).Email: JODI.HOLTROP@CUANSCHUTZ.EDUDOI: 10.3122/jabfm.2022.220224R1Keywords: Body Composition, Colorado, Family Medicine, Linear Regression, Primary Health Care, Weight LossDates: Submitted: 06-24-2022; Revised: 08-12-2022; Accepted: 08-17-2022
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BACKGROUND: Primary care practices can help patients address obesity through weight loss, however, there are many barriers to doing so. This study examined weight management services provided and factors associated with higher reported provision of services.
METHODS: A survey was given to practice members in 18 primary care practices in a Colorado-based health system. The survey assessed weight management services to determine the amount and type of weight loss assistance provided and other factors that may be important. We used descriptive statistics to summarize responses and linear regression with generalized estimating equations to assess the association between the practice and practice member characteristics and the amount of weight management services provided.
RESULTS: The overall response rate was 64% (254/399). On average, clinicians reported performing 73% of the services, and when grouped into minimal, basic, and extensive, the clinicians on average performed 87%, 68%, and 69% of them respectively. In a multivariable model adjusted for demographics, factors associated with performing more services included perception of overall better practice culture (more pleasant and productive work environment , less chaos, better change culture) (p=0.004) and perception of weight management implementation climate (support for, recognition and expectation to support weight loss) (p=0.07). Not associated in bivariate analyses were practice-level measures and clinician-specific scores for work satisfaction, and satisfaction with and assessment of appropriateness for practice provision of weight loss services.
CONCLUSIONS: Practice-associated factors such as culture and implementation climate may be worth examining to understand how to implement weight management in primary care.