Department of Internal Medicine, University of Utah, 30 North Mario Capecchi Dr, 3rd floor South, Salt Lake City, Utah 84112, USA.
Department of Family and Preventive Medicine, University of Utah, 303 Chipeta Way, Ste. 400, Salt Lake City, Utah 84108, USA.
Transl Behav Med. 2024 Nov 16;14(11):661-672. doi: 10.1093/tbm/ibae047.
Maintaining a healthy weight postintentional weight loss is crucial for preventing chronic health conditions, yet many regain weight postintervention. Electronic health record (EHR) portals offer a promising avenue for weight management interventions, leveraging patient-primary care relationships. Our previous research demonstrated that coaching alongside self-monitoring improves weight maintenance compared to monitoring alone. Integrating weight management into routine clinical practice by training existing staff could enhance scalability and sustainability. However, challenges such as inconsistent staff qualifications and high coach turnover rates could affect intervention effectiveness. Standardizing services, training, and coaching continuity seem crucial for success. To report on developing, testing, and evaluating an EHR-based coaching training program for clinical staff, guided by an implementation tool for the MAINTAIN PRIME study. Conducted across 14 University of Utah primary care sites, we developed, tested, and evaluated a coaching training for clinical staff. Guided by a planning model and the Predisposing, Enabling, and Reinforcing (PER) tool, stakeholders actively participated in planning, ensuring alignment with clinic priorities. All clinical staff were invited to participate voluntarily. Evaluation measures included staff interest, training effectiveness, confidence, and readiness. Data collection utilized REDCap, with survey results analyzed using descriptive statistics. Despite increased clinical workload and reassignments posed by coronavirus disease 2019, we were able to train 39 clinical staff, with 34 successfully coaching patients. Feedback indicated high readiness and positive perceptions of coaching feasibility. Coaches reported satisfaction with training, support, and enjoyed establishing connections with patients. The PER strategies allowed us to implement a well-received training program found effective by primary care coaches.
维持减肥后的健康体重对于预防慢性健康问题至关重要，但许多人在干预后会体重反弹。电子健康记录（EHR）门户为体重管理干预提供了一个有前途的途径，利用了患者与初级保健医生的关系。我们之前的研究表明，与单独监测相比，指导加自我监测可改善体重维持。通过培训现有员工将体重管理纳入常规临床实践可以提高可扩展性和可持续性。然而，员工资格不一致和教练离职率高等挑战可能会影响干预效果。标准化服务、培训和教练连续性似乎对成功至关重要。为了报告根据 MAINTAIN PRIME 研究的实施工具，为临床工作人员开发、测试和评估基于 EHR 的指导培训计划的情况。该研究在犹他大学的 14 个初级保健站点进行，我们为临床工作人员开发、测试和评估了一项指导培训。在规划模型和促进、促成和强化（PER）工具的指导下，利益相关者积极参与规划，确保与诊所的优先事项保持一致。所有临床工作人员都被邀请自愿参加。评估措施包括员工兴趣、培训效果、信心和准备情况。数据收集使用了 REDCap，使用描述性统计分析了调查结果。尽管 2019 年冠状病毒病导致临床工作量增加和重新分配，但我们成功培训了 39 名临床工作人员，其中 34 名成功为患者提供了指导。反馈表明准备度高，对指导可行性的看法积极。教练报告对培训、支持感到满意，并喜欢与患者建立联系。PER 策略使我们能够实施一项受欢迎的培训计划，该计划得到了初级保健教练的认可。
