Managing Obesity in Primary Care: Training Clinicians & Staff in Patient Behavior Change Skills Obesity is a major health problem in Texas, as well as a risk factor for developing cancer. Unfortunately, poor diet and physical inactivity may soon overtake tobacco as the leading cause of death in this country. These findings suggest that a more preventive approach is needed in U.S. health care. Primary care physicians are well-placed to approach their patients about safe weight loss, healthy diets, and regular physical activity, but often feel poorly prepared to do so.

The goal of this educational project is to prevent or reduce obesity by providing primary care clinicians and practice staf...

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Training Clinicians & Staff in Patient Behavior Change Skills Obesity is a major health problem in Texas, as well as a risk factor for developing cancer. Unfortunately, poor diet and physical inactivity may soon overtake tobacco as the leading cause of death in this country. These findings suggest that a more preventive approach is needed in U.S. health care. Primary care physicians are well-placed to approach their patients about safe weight loss, healthy diets, and regular physical activity, but often feel poorly prepared to do so.

The goal of this educational project is to prevent or reduce obesity by providing primary care clinicians and practice staff with the counseling skills and patient-help resources needed to bring about behavior change among overweight or obese patients. We will recruit 30 primary care sites from among member practices of the South Texas Ambulatory Research Network (STARNet), and also recruit practices from the Southwest Research Network (a collaboration of 5 federally-qualified health centers who have expressed an interest in this project).

We will work with educational experts to create a practice-friendly intervention to train clinicians and staff about 4 key “microskills” essential to Motivational Interviewing, building on a similar program proven in another setting. We will train clinicians and practice staff in counseling skills, such as 1) inform physicians about ways to listen to and respond to issues that are important to their patients, 2) helping patients set a health agenda, 3) help doctors assess the importance of this agenda and help them assess whether their patients have the confidence to make needed changes, and 4) teach physicians skills for sharing information in a way that encourages patients to begin healthy changes.

We will also provide practices with patient-level behavior-change toolkits that will help patients take advantage of the behavior-change counseling they receive from their primary care physician. These toolkits will include helpful items such as pedometers (i.e., step counters), diet diaries, physical activity logs, tip sheets for healthy diets, regular physical activity, and safe weight loss, and a list of approved online resources that can support their patients’ new healthy behaviors.

We will assess the effect of this counseling by tracking each patient’s perception of the Importance of change, and their Confidence in the ability to change. We will track each patient’s weight and assess patient diet and physical activity changes using brief questionnaires. We will work with experts around the state to share these proven materials with primary care physicians across Texas. And we will post training videos and practice- and patient-level handouts on a website so that more physicians and staff can use them with their patients.

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