用于初级保健中激活体重管理讨论的简短筛查工具的临床实用性（AWARE）：一项全国范围的混合方法试点研究。
Clinical usefulness of brief screening tool for activating weight management discussions in primary cARE (AWARE): A nationwide mixed methods pilot study.
机构信息
School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia.
Discipline of Medicine, Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Nepean, New South Wales, Australia.
出版信息
PLoS One. 2021 Oct 28;16(10):e0259220. doi: 10.1371/journal.pone.0259220. eCollection 2021.
OBJECTIVE
The Edmonton Obesity Staging System (EOSS) is based on weight related health complications among individuals with overweight and obesity requiring clinical intervention. We aimed to assess the clinical usefulness of a new screening tool based on the EOSS for activating weight management discussions in general practice.
METHODS
We enrolled five General Practitioners (GPs) and 25 of their patients located nationwide in metropolitan areas of Australia to test the feasibility, acceptability, and accuracy of the new 'EOSS-2 Risk Tool', using cross-sectional and qualitative study designs. Diagnostic accuracy of the tool for the presence of EOSS ≥2 criteria was based on clinical information collected prospectively. To assess feasibility and applicability, we explored the views of GP and patient participants by thematic analysis of transcribed verbatim and de-identified data collected by semi-structured telephone interviews.
RESULTS
Nineteen (76%) patients were aged ≥45 years, five (20%) were male, and 20 (80%) were classified with obesity. All 25 patients screened positive for EOSS ≥2 criteria by the tool. Interviews with patients continued until data saturation was reached resulting in a total of 23 interviews. Our thematic analysis revealed five themes: GP recognition of obesity as a health priority (GPs expressed strong interest in and understanding of its importance as a health priority); obesity stigma (GPs reported the tool helped them initiate health based and non-judgmental conversations with their patients); patient health literacy (GPs and patients reported increased awareness and understanding of weight related health risks), patient motivation for self-management (GPs and patients reported the tool helped focus on self-management of weight related complications), and applicability and scalability (GPs stated it was easy to use, relevant to a range of their patient groups, and scalable if integrated into existing patient management systems).
CONCLUSION
The EOSS-2 Risk Tool is potentially clinically useful for activating weight management discussions in general practice. Further research is required to assess feasibility and applicability.
目的
埃德蒙顿肥胖分期系统（EOSS）是基于超重和肥胖人群中与体重相关的健康并发症而建立的，这些并发症需要临床干预。我们旨在评估一种新的筛查工具的临床实用性，该工具基于 EOSS，用于在普通实践中启动体重管理讨论。
方法
我们招募了全国范围内位于澳大利亚大都市地区的 5 名全科医生（GPs）和 25 名患者，使用横断面和定性研究设计来测试新的“EOSS-2 风险工具”的可行性、可接受性和准确性。该工具对 EOSS≥2 标准的存在的诊断准确性基于前瞻性收集的临床信息。为了评估可行性和适用性，我们通过对通过半结构化电话访谈收集的转录逐字记录和去识别数据的主题分析，探讨了 GP 和患者参与者的观点。
结果
19 名（76％）患者年龄≥45 岁，5 名（20％）为男性，20 名（80％）为肥胖。所有 25 名患者均通过工具筛查出 EOSS≥2 标准阳性。对患者的访谈一直持续到数据饱和，共进行了 23 次访谈。我们的主题分析揭示了五个主题：GP 将肥胖视为健康优先事项的认识（GP 对其作为健康优先事项的重要性表现出强烈的兴趣和理解）；肥胖耻辱感（GP 报告该工具帮助他们与患者进行基于健康的非评判性对话）；患者健康素养（GP 和患者报告说，他们对与体重相关的健康风险有了更多的认识和理解）；患者自我管理的动机（GP 和患者报告说，该工具帮助他们专注于与体重相关并发症的自我管理）；适用性和可扩展性（GP 表示，它易于使用，与他们的一系列患者群体相关，并且如果集成到现有的患者管理系统中，则具有可扩展性）。
结论
EOSS-2 风险工具对于在普通实践中启动体重管理讨论具有潜在的临床意义。需要进一步研究来评估可行性和适用性。
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