Coordinating Pragmatic Primary care Population management for Obesity (C3PO)

Northwestern University At Chicago, Evanston IL

Investigators

Linked publications, trials & patents

Abstract

Project Summary Several prior lifestyle intervention trials have provided a strong evidence-base for the minimum intensity and necessary components of behavioral programs that are effective in achieving clinically meaningful weight loss by overweight or obese adults with cardio-metabolic risk factors. Translational studies implementing those intensive programs in ?real world? settings report near-comparable effectiveness for a lower cost, but unfortunately, overall participation in these programs, or ?reach,? has remained low. One proposed opportunity to expand reach is to link interventions with efforts of the primary health care sector, which already engages more than 80% of American adults and provides a potential gateway to third-party payment of intervention costs by health insurance programs or plans. Unfortunately, past efforts to implement intensive lifestyle interventions within busy primary care practice settings have reported significant challenges that impede sustained implementation. For this reason, the US Preventive Services Task Force recommended in August 2014 that primary care clinicians offer access to intensive interventions by providing linkages to intensive community programs. Unfortunately, there is little research about how best to provide linkages routinely in primary care, or whether such strategies actually improve reach and population-level effectiveness. The proposed Coordinating Pragmatic Primary care Population management for Obesity (C3PO) Study will address prevailing gaps between evidence and practice by engaging patients and other stakeholders to design, implement, and pilot-test a pragmatic and generalizable framework for population management of obesity that leverages existing primary care professionals and technologies to implement a scalable approach for population obesity management that coordinates primary care services with extant intensive lifestyle interventions in community settings to achieve wider reach and population-level effectiveness. This planning grant will provide a critical demonstration of feasibility and a rigorous preliminary evaluation of this novel population management approach. The findings from this pilot phase will be pivotal in helping us to optimize the intervention design and to prepare a larger and more definitive future comparative effectiveness trial.