Asselin Jodie, Salami Eniola, Osunlana Adedayo M, Ogunleye Ayodele A, Cave Andrew, Johnson Jeffrey A, Sharma Arya M, Campbell-Scherer Denise L
Affiliations: Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Family Medicine (Salami, Cave, Campbell-Scherer); Division of Endocrinology (Osunlana, Ogunleye, Sharma), Department of Medicine; School of Public Health (Johnson); Alberta Diabetes Institute (Campbell-Scherer, Sharma, Johnson), University of Alberta, Edmonton, Alta.
CMAJ Open. 2017 Apr 26;5(2):E322-E329. doi: 10.9778/cmajo.20160090.
The 5As [Ask, Assess, Advise, Agree, Assist] of Obesity Management Team study was a randomized controlled trial of an intervention that was implemented and evaluated to help primary care providers improve clinical practice for obesity management. This paper presents health care provider perspectives of the impacts of the intervention on individual provider and team practices.
This study reports a thematic network analysis of qualitative data collected during the 5As Team study, which involved 24 chronic disease teams affiliated with family practices in a Primary Care Network in Alberta. Qualitative data from 28 primary care providers (registered nurses/nurse practitioners [ = 14], dietitians [ = 7] and mental health workers [ = 7]) in the intervention arm were collected through semistructured interviews, field notes, practice facilitator diaries and 2 evaluation workshop questionnaires.
Providers internalized 5As Team intervention concepts, deepening self-evaluation and changing clinical reasoning around obesity. Providers perceived that this internalization changed the provider-patient relationship positively. The intervention changed relations between providers, increasing interdisciplinary understanding, collaboration and discovery of areas for improvement. This personal and interpersonal evolution effected change to the entire Primary Care Network.
The 5As Team intervention had multiple impacts on providers and teams to improve obesity management in primary care. Improved provider confidence and capability is a precondition of developing effective patient interventions. ClinicalTrials.gov, no.: NCT01967797.
肥胖管理团队研究的5A法（询问、评估、建议、商定、协助）是一项随机对照试验，该干预措施已实施并进行了评估，以帮助初级保健提供者改善肥胖管理的临床实践。本文介绍了医疗保健提供者对该干预措施对个体提供者和团队实践影响的看法。
本研究报告了对5A团队研究期间收集的定性数据进行的主题网络分析，该研究涉及艾伯塔省一个初级保健网络中隶属于家庭医疗的24个慢性病团队。通过半结构化访谈、实地记录、实践促进者日记和2份评估研讨会问卷，收集了干预组28名初级保健提供者（注册护士/执业护士[ = 14]、营养师[ = 7]和心理健康工作者[ = 7]）的定性数据。
提供者将5A团队干预概念内化，深化了自我评估并改变了围绕肥胖的临床推理。提供者认为这种内化对医患关系产生了积极影响。干预改变了提供者之间的关系，增强了跨学科理解、协作并发现了改进领域。这种个人和人际层面的演变对整个初级保健网络产生了影响。
5A团队干预对提供者和团队产生了多重影响，以改善初级保健中的肥胖管理。提高提供者的信心和能力是开展有效的患者干预措施的前提条件。ClinicalTrials.gov编号：NCT01967797。
