Primary Care Patients’ and Providers’ Perspectives about an Online Weight Management Program: a Qualitative Study

Abstract

BACKGROUND: Primary care providers (PCPs) often take the lead role in caring for patients with overweight and obesity; however, few PCPs counsel patients about weight loss. Online weight management programs that are integrated within primary care may help address this gap in care. OBJECTIVE: To identify perceptions of and experience with online weight management programs in general and with a proposed online program, to identify barriers to use, and to improve the design and content of our intervention, which included an online program plus population health management (PHM) support from primary care practices. DESIGN: A mixed qualitative methods study including three patient focus groups and seven semi-structured interviews with healthcare providers. PARTICIPANTS: A total of 13 adult patients (age range, 20-70) with body mass index (BMI) 27-35 kg/m 2 attended the focus groups. In-person semi-structured interviews were conducted with seven healthcare providers (three PCPs, two population health managers, one primary care nurse, and one registered dietitian). MAIN MEASURES: We developed and used semistructured focus groups and interview guides. The focus group and interviews were recorded and transcribed. Using grounded theory, we analyzed the transcripts to identify and extract common concepts and themes. KEY RESULTS: Although patients and healthcare providers expressed positive opinions about online weight management programs, few patients had experience with them, and providers stated that such programs are not being widely implemented in primary care settings. Some participants highlighted the flexibility and low cost as strengths of online weight management tools compared with in-person programs. All participants had favorable opinions about our proposed intervention and were overwhelmingly positive about the combination of an online program and PHM support. CONCLUSIONS: This study highlights the potential value of online weight management programs and PHM support in primary care. CLINICAL TRIALS REGISTRATION: NCT02656693.

A systematic review of patient barriers and facilitators for implementing lifestyle interventions targeting weight loss in primary care

“…The total number of adults and children (excluding parents) who were interviewed was 895. More women participated in the studies, although one study targeted men as the lifestyle intervention was specifically made for men with obesity 25 The interventions included e‐health interventions, 26,27 existing commercial programs, 28,29 and newly developed lifestyle interventions 25,30–33 . The e‐health or commercial programs were incorporated within primary care, required referral by their GP, 28 or involvement of a HCP 26,27,29 .…”

“…The theme “psychological factors” contains several factors of individuals, such as motivation, confidence, and stress. It was reported by 23 studies, of which 23 identified barriers 25–30,32,33,35,38–51 and 12 identified facilitators 25,28–30,33,40,41,43,46–48,51 . These include barriers such as the motivation and self‐confidence of the individual, the lack of trust in the intervention, poor knowledge of health risks associated with their weight, and stress perceived by the individual.…”

“…The theme of the “role of program staff” focuses on HCPs directly involved in the lifestyle intervention program, of which 15 studies reported on. Eight studies described barriers, 26,32,33,35,37,39,43,50 and 11 described facilitators 27,35,38,39,42,43,45,47,49–51 . The two most commonly reported barriers were a lack of active follow‐up and program staff being difficult to reach for participants.…”

Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change

“…Based on patient and stakeholder input, we selected and adapted an evidence-based online weight management program called BMIQ (Intellihealth Inc) (eTable 1 in Supplement 2). This program can be accessed via a computer, tablet, or smartphone and has patient and professional interfaces.…”

Understanding the perceptions of parents and preschool principals on the determinants of weight management among Iranian preschoolers: A directed qualitative content analysis

“…The increased risk of physical disorders, such as cardiovascular diseases, cancer, liver steatosis and psychological disorders, like low self-esteem, body image concerns, depression, and weak socialization, can be linked to overweight during childhood [ 6 – 9 ]. Therefore, early childhood has been recognized as a crucial period to determine the risk factors of obesity and establish a healthy lifestyle to prevent obesity and other chronic diseases and their complications [ 5 , 10 ].…”