Department of Internal Medicine and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
Patient Educ Couns. 2010 Jun;79(3):338-43. doi: 10.1016/j.pec.2010.01.025. Epub 2010 Mar 24.
Obesity has become a public health epidemic in adults and children. Clinician practices need new models to effectively address overweight in patients, yet, practices lack time and resources. We tested a clinician-delivered intervention that utilized community resources for in-depth counseling for unhealthy behaviors including overweight.
Eligible patients in nine primary care practices were identified using an electronic linkage system (eLinkS) which also automated patient referrals to group (Weight Watcher's), telephone counseling (TC), or usual care. Pre/post-survey data were used to assess factors related to counseling choices as well as changes in BMI (kg/m(2)) and weight-related behaviors using descriptive statistics, unadjusted, and adjusted statistical analyses.
Study sample (n=146) was 70% female with a mean age of 57 years. More patients (57%) selected WW, followed by usual care (27%) or TC (16%). Age, gender, clinician recommendation, and counseling program characteristics were influential in counseling selections. Weight Watcher's participants and those in TC, reported statistically significant weight loss, WW participants also reported significant increases in fruit/vegetable intake; after 4 months compared with usual care.
This practice-based intervention utilizing community counseling referrals was associated with positive health behavior change.
Identifying influential factors related to patient weight counseling choices may help guide referrals to community programs.
肥胖已成为成年人和儿童的公共健康问题。临床医生的实践需要新的模式来有效地解决患者超重问题,但实践缺乏时间和资源。我们测试了一种临床医生提供的干预措施,该措施利用社区资源为包括超重在内的不健康行为提供深入咨询。
使用电子链接系统(eLinkS)识别出九家初级保健诊所中符合条件的患者,该系统还自动将患者转介给小组(Weight Watcher's)、电话咨询(TC)或常规护理。使用描述性统计、未调整和调整后的统计分析,使用预/后调查数据评估与咨询选择相关的因素以及 BMI(kg/m²)和与体重相关的行为变化。
研究样本(n=146)中 70%为女性,平均年龄为 57 岁。更多的患者(57%)选择 WW,其次是常规护理(27%)或 TC(16%)。年龄、性别、临床医生的建议和咨询计划的特点对咨询选择有影响。Weight Watcher's 的参与者和 TC 的参与者报告了体重的统计学显著减轻,WW 的参与者还报告了水果/蔬菜摄入量的显著增加;与常规护理相比,在 4 个月后。
这种利用社区咨询转介的基于实践的干预措施与积极的健康行为改变有关。
确定与患者体重咨询选择相关的影响因素可能有助于指导向社区计划的转介。