Putting an Online Weight Management Program in Place in Clinical and Community Settings

Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

	This PCORI-funded implementation project is putting a weight management program that includes online education and additional support in place at clinics to help patients manage their weight.
More than 70% of U.S. adults have overweight or obesity. Clinical guidelines recommend lifestyle interventions and counseling to support weight loss for all patients with obesity and for patients with overweight who have cardiovascular risk factors or obesity-related comorbidities. But clinicians, such as doctors or nurses, have limited time during clinic visits to support weight management.

What is the goal of this implementation project?

Programs that support lifestyle changes like healthy eating and exercise can help patients manage their weight. A PCORI-funded research study adapted a 12-month online weight management program and combined it with support from population health managers, who are non-clinical staff who help primary care clinics. Compared with patients who received usual care or the online program alone, patients who received the combined program lost more weight after one year. They also felt more confident about losing weight.

This project is putting the combined approach in place at clinics in Massachusetts to help patients manage their weight.

What will this project do?

The project team is working with eight sites connected to a Massachusetts health system. The team is adapting the combined approach for specialty clinics and community settings and for diverse patients, including those at risk for heart problems.

Patients can use the online program to access education, meal plans and recipes, and tools for tracking weight, diet, and activity. A coach checks in with patients regularly to give guidance and feedback and to answer questions.

The project team will work with sites to:

Train patient navigators to serve patients across multiple clinical settings. Navigators help enroll patients, monitor their progress, and update clinicians.
Train clinicians and clinic staff to manage overweight and obesity, refer patients to the program, and work with patient navigators.
Add the online program to the electronic health record, or EHR, system to help clinic staff identify and refer patients to services.
Identify clinician champions at each site to promote the program.
Provide sites with ongoing support, including through monthly meetings.
Create a guide to help other clinics use the program in the future.

What is the expected impact of this project?

The project is demonstrating what’s required to put the program in place at clinics with diverse staffing structures and workflows.

At least 5,000 patients will receive the program. The project evaluation will confirm that the program is working as intended to help patients with overweight or obesity manage their weight.

More about this implementation project:

Stakeholders Involved in This Project

Patient and Stakeholder Advisory Council
Clinician champions at each site
The Obesity Society
Obesity Action Coalition
AllWays Health Partners

Implementation Strategies

Adapt the program to work with sites’ existing resources and workflows. Adaptations include transferring roles from population health managers to patient navigators, modifying protocols to work for specialty clinics and community-based wellness sites, and serving patients with increased cardiovascular risk and/or other health issues.
Integrate the online weight management program with the EHR or other systems to facilitate patient identification, referral, and monitoring.
Provide sites with tools to support implementation, including implementation protocols, guides, and EHR-based patient referral tools.
Provide online education modules and materials to patients as part of the online weight management program.
Train patient navigators to deliver the program, including how to enroll and monitor patients and refer them to weight management resources and services.
Identify and prepare clinician champions at sites.
Provide technical assistance to sites, including ongoing consultation, quarterly audits on patient navigator protocols, and monthly meetings with clinic staff.
Develop an implementation guide to support further use of the program at other sites.

Evaluation Outcomes

To document implementation:

Number and proportion of eligible patients referred to and enrolled in program
Patient use of the online program and contacts with coaches and/or navigators
Patient and clinician barriers or facilitators to program implementation
Maintenance (program usage six months after implementation)

To assess healthcare and health outcomes:

Patients’ weight
Patients’ cardiometabolic outcomes (blood pressure, cholesterol, triglycerides, Hemoglobin A1c)
Patients’ self-reported outcomes (health status, self-efficacy around weight loss, diet, physical activity, satisfaction)
Patient referrals to and use of other weight management services
Clinicians’ knowledge, attitudes, and behaviors about management of overweight and obesity

Project Information

Principal Investigator Principal Investigator The lead researcher and primary contact for the project. View Glossary:

Heather J. Baer, ScD

Organization Organization The institution/organization in which the project originates, or the primary institution or organization that received funding for the project. View Glossary:

Brigham and Women's Hospital

Project Budget:

$2,098,799

Project Title Project Title The original title of the project supplied by the principal investigator or project lead/team. View Glossary:

Implementation of an Online Weight Management Program in Clinical and Community Settings

Key Dates

Board Approval Date Board Approval Date The date of approval to fund by the PCORI Board of Governors. The actual project start dates vary as the negotiation of project milestones must be completed before the contract can be fully executed. View Glossary:

September 2021

Project End Date Project End Date Includes the research project period and may be subject to modification to allow other research-related activities such as peer review. View Glossary:

January 2025

Year Awarded Year Awarded The year that funding for the project was approved, or the year the proposal received a notice of award. View Glossary:

2021

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Testing an Online Program with and without Health Management Support to Help Patients Manage Their Weight

About

Research

Impact

Highlights of PCORI-Funded Research Results

Topics

Engagement

Funding Opportunities

Applicant and Awardee Resources

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