Priorities and Preferences for Weight Management and Cardiovascular Risk Reduction in Primary Care

Abstract

Implementing behavioral interventions for cardiovascular risk reduction and weight management is challenging in primary care. Primary care patients and providers were recruited for qualitative interviews to identify priorities and preferences for addressing weight management. Thematic analysis was used to identify relevant resources, barriers to lifestyle modification, health behavior change, and implementation of weight management strategies into care. Patients and providers prioritized increasing physical activity and healthy diets when managing chronic disease; and reported decreased patient motivation, knowledge, and limited organizational capacity and time among providers to deliver intensive interventions. Providers and patients disagreed regarding who owns accountability for weight management.

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

“…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.…”

“…Twenty‐six studies reported on the program structure of the lifestyle intervention, of which 19 reported on barriers, 27–29,31–35,37–41,43,45,46,48–50 including disliking certain aspects of the group sessions, feeling that the individual is not the target population, a lack of personalized approach, the program being too much effort, program tools are difficult to use, and the program having too much time between follow‐ups; 25 studies reported on facilitators 25–29,31–36,38–43,45–52 . The most commonly reported facilitators were a program with a personalized approach, liking certain aspects of group sessions, liking certain aspects of the program, monitoring of health and weight status, and programming tools that were seen as helpful and flexibility in scheduling the sessions.…”

Patient Characteristics Associated with Receipt of Prescription Weight‐Management Medications Among Veterans Participating in MOVE!

“…Treatment for obesity in general tends to be suboptimal, per ambulatory care performance on quality indicators for patients with obesity outside the VHA . The barriers to obesity treatment reported by patients include a perceived lack of support from clinicians , and the barriers reported by primary care providers (PCPs) include a perceived lack of effective treatments for obesity, inadequate reimbursement for time spent on weight management, and frustration with patients’ inability to lose weight . On top of these challenges, PCPs report barriers to use of WMM specifically; these include limited experience and concern about adverse reactions to WMM .…”

Translating hunger training research to primary health: a qualitative study of nurse attitudes towards a novel weight management intervention

“…This is consistent with similar studies reporting patient motivation as the key to the success of guideline and programme implementation. [20][21][22] Financial costs, time resources and workload are well reported barriers to the implementation of interventions in primary care. [21][22][23] Nurses in this study repeatedly commented on financial cost, most often from the perspective of patients, as a barrier to patient interest in hunger training.…”