A patient-centredness improvement study for efficacy of behaviour change for healthy lifestyle and weight loss in a student-run free clinic

Abstract

Background Primary care is the ideal place to implement behaviour change interventions for weight management. However, most primary care physicians are not managing patient weight as a standard of care due to lack of knowledge, skills and reimbursement. Generating more physicians who are familiar and comfortable with providing weight management is essential in leveraging a global change. In our university free clinic, medical students provide healthy lifestyle counselling using shared decision making to each patient at every clinic visit. Objective Improve the efficacy of behaviour change interventions via increased patient responsiveness and adherence. Methods The needs assessment demonstrated a subpar patient response rate to check-ins regarding behavioural change goals. In the first and second interventions, check-in message structure and contact schedule were varied to maximize patient responsiveness and goal achievement. Results In the needs assessment, 58% of patients responded to follow-ups and 58% of patients accomplished their goal. The first intervention cycle resulted in an improvement of responsiveness to 70% and accomplishment of goals to 59%. The second intervention cycle resulted in an improvement of responsiveness to 78% and accomplishment of goals to 74%. Conclusions Messages that were frequent, unique, succinct and delivered within 4 weeks after the clinic visit resulted in the highest response rate and goal attainment. Other primary care clinics can use these interventions to increase patient completion of implemented behaviour changes for a healthier lifestyle.

Low Carb Program Health App Within a Hospital-Based Obesity Setting: Observational Service Evaluation

“…Furthermore, the integrated use of digital health care technology within established clinical pathways aligns with NHS priorities, such as supporting the prevention of obesity-related disease and the transition toward digitally enabled health care [ 10 ]. The current literature provides supportive evidence for the popularity of self-monitoring tools [ 27 ], interactivity with other users [ 28 ] and messages enabling frequent check-ins [ 29 ] among patients attending weight management services generally. A recent narrative review on the use of digital technology in the context of weight management concluded that while evidence exists to support the usefulness of digital interventions in obesity management, this field remains largely unexplored [ 30 ], with a lack of acknowledgment of the role of digital tools within national policies [ 31 ].…”