Kansas Primary Care Weighs In: A Pilot Randomized Trial of a Chronic Care Model Program for Obesity in 3 Rural Kansas Primary Care Practices

Authors

  • Andrea C. Ely MD, MSc,

    1. Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kan.
    2. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kan.
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  • Angela Banitt MA,

    1. Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kan.
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  • Christie Befort PhD,

    1. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kan.
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  • Qing Hou MS,

    1. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kan.
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  • Paula C. Rhode PhD,

    1. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kan.
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  • Chrysanne Grund MA,

    1. Greeley County Health System, Tribune, Kan.
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  • Allen Greiner MD, MPH,

    1. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kan.
    2. Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kan.
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  • Shawn Jeffries PhD,

    1. Department of Behavioral Sciences, School of Public Health, University of North Texas, Dallas, Tex.
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  • Edward Ellerbeck MD, MPH

    1. Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kan.
    2. Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kan.
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  • This work was supported by an American Heart Association Heartland Affiliate Beginning Grant-in-Aid #0560057Z to Dr. Ely. The authors gratefully acknowledge the physicians, staff, and patients of the Greeley County Health System, Tribune, Kan, and the Bluestem Medical Group, Quinter, Kan. This research would not have been possible without their eager participation and supportive efforts. For further information, contact: Andrea C. Ely, MD, Division of General and Geriatric Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd., Wescoe 5026, MSN 1020, Kansas City, KS 66160; e-mail aely@kumc.edu.

Abstract

ABSTRACT: Context:Obesity is a chronic disease of epidemic proportions in the United States. Primary care providers are critical to timely diagnosis and treatment of obesity, and need better tools to deliver effective obesity care. Purpose: To conduct a pilot randomized trial of a chronic care model (CCM) program for obesity care in rural Kansas primary care. Methods: We enrolled 107 participants to a 6-month, 2-armed, randomized trial comparing a CCM for obesity with usual care. The primary outcome was weight change at 90 days. The usual care arm received educational weight loss materials and outcome assessments at day 0, 90, and 180. The active arm received the same elements as the usual care arm plus a multicomponent obesity CCM. Findings: The Day 90 mean ± SD weight change for the active arm (n = 34) and control arm (n = 33), respectively, was −4.5 ± 7.7 pounds and −2.4 ± 8.1 pounds (P = .27 for difference). The Day 180 mean ± SD weight change for the active (n = 27) and control (n = 27) arms, respectively, was −9.4 ± 10.3 pounds and −2.1 ± 10.7 pounds (P = .01 for difference). There was no significant change in physical activity, or fruit and vegetable intake at day 90 or day 180. Conclusions: Improving the recognition and treatment of obesity in primary care settings is a critical initiative. Rural populations suffer disproportionately with obesity, and better methods of delivering obesity care are needed for this population. Further research is needed to establish the effectiveness of a CCM approach for obesity care.

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