Building a Viable Weight Management Program in a Patient-Centered Medical Home

Wilhoit-Reeves, Stephanie B; Sisler, Laurel; Aymes, Shannon; Ortiz-Pujols, Shiara; Porterfield, Deborah S; Goldstein, Adam O.

doi:10.22454/fammed.2020.418736

Cited by 4 publications

(5 citation statements)

References 9 publications

(9 reference statements)

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“…The first eight sessions followed the 8‐week AAT programme, a CBT‐focused intervention for binge eating that emphasizes appetite self‐regulation, which has been described elsewhere 9,10 . After the initial 8 weeks, the group transitioned to eight LM‐focused sessions informed by the diabetes prevention programme's prevent T2 curriculum, utilized at the same family medicine centre where recruitment took place 17,27 . Session content included discussions of food shopping and label reading, physical activity, nutrients and types of food (e.g., protein, vegetables, carbohydrates and heart‐healthy fats), eating away from home, setting SMART (i.e., specific, measurable, action‐oriented, realistic and time‐bound) goals and identifying and replacing cognitive distortions related to weight management.…”

Section: Methodsmentioning

confidence: 99%

“…9,10 After the initial 8 weeks, the group transitioned to eight LM-focused sessions informed by the diabetes prevention programme's prevent T2 curriculum, utilized at the same family medicine centre where recruitment took place. 17,27 Session content included discussions of food shopping and label reading, physical activity, nutrients and types of food (e.g., protein, vegetables, carbohydrates and heart-healthy fats), eating away from home, setting SMART (i.e., specific, measurable, action-oriented, realistic and time-bound) goals and identifying and replacing cognitive distortions related to weight management. Participants did not receive any specific energy intake prescription; they were encouraged to participate in physical activity.…”

Section: Interventionmentioning

confidence: 99%

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Creating an appetite awareness and lifestyle modification intervention for Black women at risk for binge eating disorder: A pilot open trial

et al. 2023

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SummaryDespite the availability of evidence‐based interventions to improve binge eating, Black women have some of the lowest rates of access to care for eating disorders. Innovation is needed to offer accessible and culturally relevant treatment options. To this end, using an open trial design, we investigated the feasibility and acceptability of a group‐based, appetite awareness training (AAT) + lifestyle modification (LM) programme in Black women at risk for BED in a primary care setting. Participants (n = 20) were Black women recruited from a family medicine centre affiliated with a local public university, and who reported at least two binge eating episodes in the last 28 days. Participants completed a 16‐session AAT + LM programme over 4 months. Key outcomes were objective binge eating (assessed by the EDE and the EDE‐Q), body dissatisfaction, and weight change, all assessed at baseline, four (post‐treatment) and 6 months (2‐month follow‐up). Ninety‐five percent of participants completed assessments at post‐treatment and attended nearly 60% of intervention sessions. Among completers (n = 19), body dissatisfaction and objective binge eating decreased from baseline to post‐treatment and this decrease was maintained at the 2‐month follow‐up. In exit interviews, participants reported programme satisfaction. Providing training in appetite awareness combined with lifestyle modification principles may be useful in the treatment of body dissatisfaction and binge eating among Black women.

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Section: Methodsmentioning

confidence: 99%

Section: Interventionmentioning

confidence: 99%

Creating an appetite awareness and lifestyle modification intervention for Black women at risk for binge eating disorder: A pilot open trial

et al. 2023

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“…(25,26) A rigorous weight management MDC by Wilhoit-Reeves et al used family physicians, social workers, dietitians, and bariatric surgeons, with biweekly touch points for high-intensity behavioral therapy on diet and exercise, to achieve at least 5% TBWL in 1 year in 32% of patients. (27)…”

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confidence: 99%

Multidisciplinary Clinic Models: A Paradigm of Care for Management of NAFLD

et al. 2021

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ultidisciplinary clinics (MDCs) are an emerging model of health care delivery, offering patients coordinated care services to diagnose problems early and develop cohesive treatment plans. MDCs are commonly used in oncology, (1) type 2 diabetes mellitus (T2DM), (2) and women's health, (3) where they improve patient satisfaction and clinical and financial outcomes. In this review, we examine current MDC models and share a framework for patients with NAFLD to guide development of future multidisciplinary NAFLD programs. Multidisciplinary Care Models in MedicineWhile traditional health care delivery models consist of physicians assessing patients independently, MDCs promote coordinated care by integrating consultations and centralizing into a single clinic space. MDCs are often seen in oncology practices where multiple consultations are coordinated by a navigator into a single visit. (4) Many also have weekly conferences involving multiple providers who discuss and coordinate management plans and follow-up. (4,5) These models promote evidence-based, patient-centered plans and have been shown to improve clinical outcomes. (5) For example, a single-day MDC for patients with liver cancer that features a central clinical coordinator and frequent team meetings reported improvement in diagnosis, treatment, patient-provider communication, and satisfaction. (6) Despite variations in structure, MDCs are also well received by patients. In traditional sequential referral models of care, patients perceive poorer physician communication, inefficient use of time, misdiagnosis, mistreatment, and decreased satisfaction, which can lead to seeking a second opinion. (7) Conversely, patients in MDCs enjoy improved patient-physician communication and increased efficiency of travel time, appointments, and testing. (4,8) MDCs also improve patient experience and quality of life in cancer care, while reducing health care costs. (9) Multidisciplinary Care in NAFLDThe complexity of NAFLD and its associations with metabolic disease, cardiac and diabetic complications, and lifestyle factors make it ideal for multidisciplinary care. Patients with metabolic syndrome are at high risk for developing NAFLD complications, such as cirrhosis and HCC. (10) Data also suggest

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“…Key to their approach is an interprofessional team comprised of clinicians, social workers, and dietitians using a mix of nutrition guidelines and cognitive behavioral therapy techniques. 15 Our final two articles in this issue address the important topic of training residents in new, innovative practice models and approaches. Emphasizing the importance of our learners, Dr Hofkamp et al describe the potential of curricular changes in ambulatory settings to improve resident engagement and foster their well-being, demonstrating improvement in resident self-perception of personal wellness and preparedness reflected in postimplementation survey results.…”

mentioning

confidence: 99%