The relative effectiveness of two styles of educational package to change practice nurses' management of obesity

Ogden, JE; Hoppe, Ruth B.

doi:10.1038/sj.ijo.0800503

Cited by 20 publications

(30 citation statements)

References 19 publications

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“…Most studies were undertaken in the US, although one was undertaken in the UK, 23 one in Australia, 21 , and one in Finland. 27 Most of the included studies focused on overweight and obesity in general, rather than speci®c clinical subgroups of overweight patients.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Other studies were undertaken in a range of settings: a US general medical clinic, 22 UK primary care, 23 both general practice and hospital outpatients, 21 inpatient and outpatient services, 27 university campuses 24,26,31 and other settings that were not clear but participants had been recruited through general newspaper advertising rather than from health care settings.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…McDonald et al 22 randomised by provider teams but analysed at the patient level. Ogden and Hoppe 23 randomised by nurses but analysed by patients. The remaining studies were randomised and analysed at the patient level.…”

Section: 28 ± 30mentioning

confidence: 99%

“…Of these, three were randomised controlled trials (RCTs) of professional-oriented interventions: two were about the use of reminders with doctors 20,22 and another was about training nurses to give advice. 23 The fourth was a controlled before and after (CBA) study of professional and organisational interventions of shared care to improve collaboration between a hospital based obesity clinic and GPs. 21 No studies were found for Comparison 2 (interventions aimed at redressing negative attitudes and related practices towards overweight and obese patients vs usual care), or Comparison 3 (organisational interventions designed to change the structure of services for overweight and obese people vs educational or behavioural interventions for health professionals).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…One of these was essentially an organisational intervention encouraging shared care among health professionals. 21 Of the other three, one was randomised by teams of providers, 22 one by individual health professionals 23 and the other by patients (and professionals). 20 …”

Section: 28 ± 30mentioning

confidence: 99%

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A systematic review of interventions to improve health professionals’ management of obesity

et al. 1999

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OBJECTIVE: To determine the existence and effectiveness of interventions to improve health professionals' management of obesity or the organisation of care for overweight and obese people. DESIGN: A systematic review of intervention studies, undertaken according to standard methods developed by the Cochrane Effective Practice and Organisation of Care (EPOC) Group. 1 PARTICIPANTS: Trained health care professionals and overweight and obese patients. MEASUREMENTS: Objective measures of health professionals' practice and behaviours, and patient outcomes including satisfaction, behaviour, psychological factors, disease status, risk factors, and measures of body weight, fat, or BMI. RESULTS: Twelve studies that met all the review inclusion criteria were identi®ed. Three were randomised controlled trials of health professional-oriented interventions (such as the use of reminders and training) and one was a controlled before and after study to improve collaboration between a hospital clinic and GPs. A further eight randomised controlled trials were identi®ed of interventions comparing either the deliverer of weight loss interventions or the setting of the delivery of the intervention. The heterogeneity and generally limited quality of identi®ed studies make it dif®cult to provide recommendations for improving health professionals' obesity management. CONCLUSIONS: At present, decisions about improving the provision of services for overweight and obese people must be based on the evidence from patient interventions and good clinical judgement. Future research is required to identify cost-effective strategies for improving health professionals' management and the organisation of care for overweight and obese people.A full version of this review, including detailed descriptions of the included studies and data tables, is available in the Cochrane Library.2 The Cochrane Library is a database of systematic review and other evidence on the effects of health care, available on CD ROM from Update Software. For further information see: http:aawww.cochrane.co.uk.

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Section: Description Of Included Studiesmentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 99%

Section: 28 ± 30mentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 99%

Section: 28 ± 30mentioning

confidence: 99%

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A systematic review of interventions to improve health professionals’ management of obesity

et al. 1999

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Improving health professionals' management and the organisation of care for overweight and obese people

Harvey¹,

Glenny²,

Kirk³

et al. 2001

Cochrane Database of Systematic Reviews

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Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese adults

Flodgren

Deane

Dickinson

et al. 2010

Cochrane Database of Systematic Reviews

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Background The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for both population health and costs to health services. Objectives To assess the effectiveness of strategies to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people. Search methods We updated the search for primary studies in the following databases, which were all interrogated from the previous (version 2) search date to May 2009: The Cochrane Central Register of Controlled Trials (which at this time incorporated all EPOC Specialised Register material) (The Cochrane Library 2009, Issue 1), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid). We identified further potentially relevant studies from the reference lists of included studies. Selection criteria Randomised controlled trials (RCTs) that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in overweight or obese adults. Data collection and analysis Two reviewers independently extracted data and assessed study quality. Main results We included six RCTs, involving more than 246 health professionals and 1324 overweight or obese patients. Four of the trials targeted professionals and two targeted the organisation of care. Most of the studies had methodological or reporting weaknesses indicating a risk of bias. Meta-analysis of three trials that evaluated educational interventions aimed at GPs suggested that, compared to standard care, such interventions could reduce the average weight of patients after a year (by 1.2 kg, 95% CI −0.4 to 2.8 kg); however, there was moderate unexplained heterogeneity between their results (I2 = 41%). One trial found that reminders could change doctors’ practice, resulting in a significant reduction in weight among men (by 11.2 kg, 95% CI 1.7 to 20.7 kg) but not among women (who reduced weight by 1.3 kg, 95% CI −4.1 to 6.7 kg). One trial found that patients may lose more weight after a year if the care was provided by a dietitian (by 5.6 kg, 95% CI 4.8 to 6.4 kg) or by a doctor-dietitian team (by 6 kg, 95% CI 5 to 7 kg), as compared with standard care. One trial found no significant difference between standard care and either mail or phone interventions in reducing patients’ weight. Authors’ conclusions Most of the included trials had methodological or reporting weaknesses and were heterogeneous in terms of participants, interventions, outcomes, and settings, so we cannot draw any firm conclusions about the effectiveness of the interventions. All of the evaluated interventions would need further investigation before it was possible to recommend them as effective strategies.

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The relative effectiveness of two styles of educational package to change practice nurses' management of obesity

Cited by 20 publications

References 19 publications

A systematic review of interventions to improve health professionals’ management of obesity

A systematic review of interventions to improve health professionals’ management of obesity

Improving health professionals' management and the organisation of care for overweight and obese people

Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese adults

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