Development of a 5As-based technology-assisted weight management intervention for veterans in primary care

Katrina F. Mateo, Natalie B. Berner, Natalie L. Ricci, Pich Seekaew, Sandeep Sikerwar, Craig Tenner, Joanna Dognin, Scott Sherman, Adina Kalet, Melanie Jay

    Research output: Contribution to journalArticle

    Abstract

    Background: Obesity is a worldwide epidemic, and its prevalence is higher among Veterans in the United States. Based on our prior research, primary care teams at a Veterans Affairs (VA) hospital do not feel well-equipped to deliver effective weight management counseling and often lack sufficient time. Further, effective and intensive lifestyle-based weight management programs (e.g. VA MOVE! program) are underutilized despite implementation of systematic screening and referral at all VA sites. The 5As behavior change model (Assess, Advise, Agree, Assist, Arrange) is endorsed by the United States Preventive Service Task Force for use in counseling patients about weight management in primary care and reimbursed by Medicare. In this paper, we describe the iterative development of a technology-assisted intervention designed to provide primary care-based 5As counseling within Patient-Centered Medical Homes without overburdening providers/healthcare teams. Methods: Thematic analyses of prior formative work (focus groups with patients [n = 54] and key informant interviews with staff [n = 25]) helped to create a technology-assisted, health coaching intervention called Goals for Eating and Moving (GEM). To further develop the intervention, we then conducted two rounds of testing with previous formative study participants (n = 5 for Round 1, n = 5 for Round 2). Each session included usability testing of prototypes of the online GEM tool, pilot testing of 5As counseling by a Health Coach, and a post-session open-ended interview. Results: Three main themes emerged from usability data analyses: participants' emotional responses, tool language, and health literacy. Findings from both rounds of usability testing, pilot testing, as well as the open-ended interview data, were used to finalize protocols for the full intervention in the clinic setting to be conducted with Version 3 of the GEM tool. Conclusions: The use of qualitative research methods and user-centered design approaches enabled timely detection of salient issues to make iterative improvements to the intervention. Future studies will determine whether this intervention can increase enrollment in intensive weight management programs and promote clinically meaningful weight loss in both Veterans and in other patient populations and health systems.

    Original languageEnglish (US)
    Article number47
    JournalBMC Health Services Research
    Volume18
    Issue number1
    DOIs
    StatePublished - Jan 29 2018

    Fingerprint

    Veterans
    Counseling
    Primary Health Care
    Technology
    Weights and Measures
    Eating
    Interviews
    Veterans Hospitals
    Health Literacy
    Patient-Centered Care
    Biomedical Technology
    Patient Care Team
    Qualitative Research
    Health
    Advisory Committees
    Medicare
    Focus Groups
    Life Style
    Weight Loss
    Language

    Keywords

    • Intervention development
    • Obesity
    • Patient centered medical home
    • Primary care
    • VETERANS

    ASJC Scopus subject areas

    • Health Policy

    Cite this

    Mateo, K. F., Berner, N. B., Ricci, N. L., Seekaew, P., Sikerwar, S., Tenner, C., ... Jay, M. (2018). Development of a 5As-based technology-assisted weight management intervention for veterans in primary care. BMC Health Services Research, 18(1), [47]. https://doi.org/10.1186/s12913-018-2834-2

    Development of a 5As-based technology-assisted weight management intervention for veterans in primary care. / Mateo, Katrina F.; Berner, Natalie B.; Ricci, Natalie L.; Seekaew, Pich; Sikerwar, Sandeep; Tenner, Craig; Dognin, Joanna; Sherman, Scott; Kalet, Adina; Jay, Melanie.

    In: BMC Health Services Research, Vol. 18, No. 1, 47, 29.01.2018.

    Research output: Contribution to journalArticle

    Mateo, KF, Berner, NB, Ricci, NL, Seekaew, P, Sikerwar, S, Tenner, C, Dognin, J, Sherman, S, Kalet, A & Jay, M 2018, 'Development of a 5As-based technology-assisted weight management intervention for veterans in primary care', BMC Health Services Research, vol. 18, no. 1, 47. https://doi.org/10.1186/s12913-018-2834-2
    Mateo, Katrina F. ; Berner, Natalie B. ; Ricci, Natalie L. ; Seekaew, Pich ; Sikerwar, Sandeep ; Tenner, Craig ; Dognin, Joanna ; Sherman, Scott ; Kalet, Adina ; Jay, Melanie. / Development of a 5As-based technology-assisted weight management intervention for veterans in primary care. In: BMC Health Services Research. 2018 ; Vol. 18, No. 1.
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