Kansas primary care weighs in: a pilot randomized trial of a chronic care model program for obesity in 3 rural Kansas primary care practices.
BACKGROUND
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.


OBJECTIVE
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.


RESULTS
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.
Ely
Andrea C
AC
Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA. aely@kumc.edu
Banitt
Angela
A
Befort
Christie
C
Hou
Qing
Q
Rhode
Paula C
PC
Grund
Chrysanne
C
Greiner
Allen
A
Jeffries
Shawn
S
Ellerbeck
Edward
E
D015992:Body Mass Index; D003376:Counseling; D004032:Diet; D019468:Disease Management; D015444:Exercise; D005260:Female; D006801:Humans; D007615:Kansas; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D010353:Patient Education as Topic / Q000458:organization & administration; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D012959:Socioeconomic Factors; D015431:Weight Loss