This project will compare two training approaches for US Preventive Services Task Force recommended obesity care in Federally Qualified Health Centers (FQHC) across four aims. Aim 1 compares patient-level effectiveness \[i.e., patient relative weight change and the proportion of patients who achieve clinically significant weight loss\]. Aim 2 compares reach (patient treatment utilization). Aim 3 compares primary care provider (PCP) referrals to USPSTF-recommended care at 12 (adoption) and 24 months (maintenance) and short- and long-term changes in provider obesity care competencies . Aim 4 compares implementation and service costs.
Provider Trainees must be PCPs, BHPs, RDNs, or CHWs who work at participating clinics.
PCPs that are eligible to participate as Provider Trainees can be any of the following: Medical Doctors (MD), Doctor of Osteopathic Medicine (DO), Physician Assistants (PA), or Nurse Practitioners (NP). PCPs must see patients in a primary care setting and be capable of referring patients to IBT and MNT. PCPs must have already completed their residency (when applicable).
BHPs that are eligible to participate as Provider Trainees must be at least one of the following categories (listed with typical credentials): Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Psychologist (PhD/PsyD), Psychiatric Nurse Practitioner, Psychiatrist (MD).
RDNs that are eligible to participate as Provider Trainees must be Registered Dietitians/Registered Dietitian Nutritionists.
Not at a participating clinic
PCPs who do not have the ability to refer to IBT or MNT
Resident Doctors
A doctor specializing in reproductive health (or related fields)
Parallel
Comprehensive Multidisciplinary Obesity Care
Other interventionCMOC is an innovative approach to obesity care delivery that leverages policy, clinical and community linkages, and digital technology for scalability. CMOC involves training providers (medical providers, registered dietitians, and behavioral health providers) to deliver guideline-based obesity care for youth and adults with obesity who receive Medicaid. Guidelines-based care involves screening, identification, weight counseling, and referral to intensive behavioral treatment by medical providers, and delivery of multicomponent intensive behavioral treatment by behavioral health providers and registered dietitians.
Implementation as Usual Control
Other interventionThe standard of care implemented in FQHCs in the absence of CMOC training.
Change in patient percent overweight
Percent over the median body mass index (BMI) for sex and age.
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Washington University School of Medicine
Lead sponsor
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Collaborator
Children's Mercy Hospital Kansas City
Collaborator
University of Missouri-Columbia
Collaborator
Missouri Institute of Mental Health
Collaborator
University of Missouri, Kansas City
Collaborator
The Missouri Department of Social Services, MO HealthNet Division, Office of Transformation
Collaborator
