AuYoung Mona, Duru O Kenrik, Ponce Ninez A, Mangione Carol M, Rodriguez Hector P
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (Drs AuYoung and Ponce); Division of General Internal Medicine & Health Services Research, Geffen School of Medicine, University of California, Los Angeles (Drs Duru and Mangione); and Division of Health Policy and Management, School of Public Health, University of California, Berkeley (Dr Rodriguez).
J Ambul Care Manage. 2015 Apr-Jun;38(2):153-63. doi: 10.1097/JAC.0000000000000063.
Teamlets of physicians and medical assistants may help improve obesity management in primary care settings. We aimed to understand the barriers and facilitators of implementing a teamlet approach to managing obesity in 3 safety net clinics. Key stakeholder interviews (n = 21) were conducted both during early implementation of practice change and 6 months later. Patient surveys (n = 393) examined obese patient activation and health status. Insufficient program resources and limited patient engagement due to external factors were implementation barriers despite fairly high patient activation. Staff members need time and resources to execute new responsibilities to support obesity management in safety net settings. Because of high turnover, multiple supporters may improve sustainability.
由医生和医疗助理组成的小组可能有助于改善基层医疗环境中的肥胖管理。我们旨在了解在3家安全网诊所实施小组方法管理肥胖的障碍和促进因素。在实践变革早期实施期间和6个月后分别进行了关键利益相关者访谈（n = 21）。患者调查（n = 393）考察了肥胖患者的积极性和健康状况。尽管患者积极性相当高，但项目资源不足以及外部因素导致的患者参与度有限仍是实施障碍。工作人员需要时间和资源来履行新职责，以支持安全网环境中的肥胖管理。由于人员流动率高，多名支持者可能会提高可持续性。
