Promoting Primary Care Provider Knowledge and Self-Efficacy in Weight Management Counseling

Abstract

Purpose: The purpose of this quality improvement project was to increase primary care providers’ intent to refer eligible veterans to the MOVE! Weight Management Program at the Southern Arizona Veterans Administration Health Care System by providing an educational tutorial on the use of the 6 “A”s Model for Weight Management Counseling. Secondarily, perceptions of and barriers to weight counseling and of the MOVE! Program were also assessed.Background: Nearly 80% of veterans are overweight or obese and have a concerning risk for developing over 200 obesity-related health conditions. Overweight and obese veterans are eligible to participate in an evidence-based lifestyle management program called MOVE! Lifestyle changes are the first line treatment for weight loss, making MOVE! a valuable resource. Despite wide availability of MOVE!, this program remains underutilized. Methods: Health care providers in a Veterans Affairs primary care clinic watched an online, asynchronous 10-minute educational tutorial on the use of the 6 “A”s Model for Weight Management Counseling and were provided with instructions on how to place a referral to the MOVE! Program in the electronic health record. A post-pre survey was used to assess change in intent to refer and change in knowledge of the 6 “A”s Model. A post survey was used to assess current perceptions of and barriers in referring to the MOVE! Program and conducting weight management counseling. Results: Four primary care providers participated in the education module and completed the survey. Although provider intent to refer and the likelihood to use each of the 6 “A”s Model components was not found to be statistically significant, there was an approach to significance with respect to intent to refer (p=0.058). Participants expressed motivation to learn more about obesity management and a positive opinion of the MOVE! Program. Identified barriers to counseling were lack of time and effective treatments and feelings of futility. Identified barriers to referrals were lack of time and knowledge and patient-specific reasons. Conclusions: Delivering education to primary care providers via an online, asynchronous tool may be an effective way to influence clinical practice behavior. Additional training on the management of overweight/obesity is desired by health care providers in the VA primary care clinic where the project was implemented. There is a positive impression of MOVE! but several barriers exist that must be overcome to increase referrals and utilization of the MOVE! Program.