Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in children and adults with overweight or obesity

Flodgren, Gerd; Gonçalves‐Bradley, Daniela C; Summerbell, Carolyn

doi:10.1002/14651858.cd000984.pub3

Cited by 45 publications

(46 citation statements)

References 132 publications

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“…A recent Cochrane review highlighted the paucity of trials in the area. 6 Moore and colleagues' ambitious trial in 44 primary care practices in England was hampered by variable uptake by practitioners, and as a result the researchers were unable to draw conclusions about the effectiveness of the intervention for patient weight loss. 25 They did demonstrate that practitioners Note: IQR = interquartile range, SD = standard deviation.…”

Section: Discussionmentioning

confidence: 99%

Changing provider behaviour to increase nurse visits for obesity in family practice: the 5As Team randomized controlled trial

Campbell‐Scherer

Asselin

Osunlana

et al. 2019

cmajo

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O besity and its chronic disease complications are surging worldwide, 1,2 but health care professionals are poorly prepared to tackle the prevention and treatment of obesity in clinical practice; deficits in knowledge about the complexity of obesity and its management, as well as the need for team-based care, contribute. 3 Evidence is sparse on how to change provider behaviour to improve obesity assessment and management in primary care. 4-6 A suite of tools and resources to support primary care providers called the 5As of Obesity Management (the 5As: ask, assess, advise, agree, assist) has been developed in Canada. 7-11 This approach emphasizes obesity as a chronic disease requiring long-term treatment, the importance of prevention, and assessment of root causes to better understand how psychosocial and medical comorbidities promote obesity. Use of the 5As has been demonstrated to improve practitioners' efficacy in providing obesity counselling 12-14 and patient weight loss. 15 The 5As Team (5AsT) program was developed in collaboration with a large primary care network (PCN) in Alberta, Canada. Our overarching research question was whether a 6-month team-based learning collaborative with educational

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Section: Discussionmentioning

confidence: 99%

Changing provider behaviour to increase nurse visits for obesity in family practice: the 5As Team randomized controlled trial

Campbell‐Scherer

Asselin

Osunlana

et al. 2019

cmajo

View full text Add to dashboard Cite

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“…This was a realist review conducted according to RAMESES standards, 16 as described in our protocol paper. 17 The search strategy was based on the Cochrane review search terms, 13 but with two key amendments. First, search terms for study type (eg, RCT) were removed to ensure that a wider range of interventions and approaches were included.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…The first assessed the effectiveness of interventions to change the behaviour of health professionals and/or the organisation of care to promote weight reduction in adults with overweight and obesity, and identified six RCTs. 13 It found evidence of a change in clinicians' behaviours after receiving an educational intervention (eg, increased recording of weight), but no statistically significant difference in patient weight between intervention and control groups.…”

mentioning

confidence: 94%

What works and why in the identification and referral of adults with comorbid obesity in primary care: A realist review

2019

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Summary Primary care practitioners (PCPs) are well placed to identify individuals with obesity and weight‐related comorbidities and to refer them to weight management services (WMS), but this does not often happen in practice. In this realist review, we searched six databases for intervention studies targeted at PCPs to improve the identification and referral of adults with comorbid obesity. Realist analysis was used to identify context‐mechanism‐outcome (CMO) configurations across 30 included papers (reporting on 27 studies). Most studies used multiple intervention strategies, categorised into: (a) training, (b) tools to improve identification, (c) tools to improve ease of referral, (d) audit/feedback, (e) working in networks/quality circles, and (f) other. The realist synthesis identified 12 mechanisms through which interventions work to improve identification and referral, including increasing knowledge about obesity and awareness of and confidence in WMS among practitioners, improved communication and trust between practitioners and WMS, and higher priority given to weight management among primary care teams. The theory of “candidacy” (a person's eligibility for medical attention and intervention) provided a robust explanatory framework but required refinement: (a) to take account of the different services (primary care and weight management) that patients must navigate to access support; and (b) to acknowledge the importance of wider contextual factors.

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“…Obesity is an increasing problem of the 21st century and one of the fastest growing health problems worldwide (Buchwald & Williams, ; Flodgren, Goncalves‐Bradley, & Summerbell, ). Obesity may contribute to the occurrence of various health conditions such as diabetes mellitus, cardiovascular disease, stroke, hypertension, and certain cancer forms (Marsicano, Sales‐Peres, Ceneviva, & de Sales‐Peres, ; Vairavamurthy, Cheskin, Kraitchman, Arepally, & Weiss, ; Vinciguerra et al, ) and associates with oral health problems such as dental caries, periodontitis, and hyposalivation (Marsicano, Sales‐Peres, Ceneviva, & de Sales‐Peres, ).…”

Section: Introductionmentioning

confidence: 99%

Perceived oral health in patients after bariatric surgery using oral health‐related quality of life measures

Karlsson

Carlsson

Jenneborg

et al. 2018

Clinical & Exp Dental Res

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Obesity is an increasing problem of the 21st century. A frequent intervention is bariatric surgery. The impact of bariatric surgery on oral health is largely unknown. The aim of the present case–control study was to survey the perceived oral health amongst individuals that had undergone bariatric surgery and compare the measures with two cohorts consisting of healthy individuals with respectively at or below versus above a body mass index score of 30. Study volunteers were recruited from interest group on the Internet. The study participants completed online a validated oral health‐related quality of life scale, that is, OHIP‐S. The three cohorts consisted of individuals that had undergone bariatric surgery (OS, n = 77) and the healthy obese (ONS, n = 45) and nonobese individuals (HNS, n = 71). Nonparametric Kruskal–Wallis rank sum tests were used to estimate likelihood of nondifference amongst the three cohorts. Individuals that had undergone bariatric surgery reported significant more oral health problems than the study participants in with the two other cohorts. Their perception of oral health‐related quality of life was higher or similar to the obese study participants and lower than for nonobese study participants. Perceived oral health problems appear to be more frequent amongst individuals that have undergone bariatric surgery in comparison with healthy obese and nonobese individuals. Bariatric surgery may be consider a risk marker for impaired oral health.

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Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in children and adults with overweight or obesity

Abstract: Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in children and adults with overweight or obesity.

Cited by 45 publications

References 132 publications

Changing provider behaviour to increase nurse visits for obesity in family practice: the 5As Team randomized controlled trial

Changing provider behaviour to increase nurse visits for obesity in family practice: the 5As Team randomized controlled trial

What works and why in the identification and referral of adults with comorbid obesity in primary care: A realist review

Perceived oral health in patients after bariatric surgery using oral health‐related quality of life measures

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