Frontline experiences of a practice redesign to improve self-management of obesity in safety net clinics.
Teamlets of physicians and medical assistants may help improve obesity management in primary care settings. We aimed to understand the barriers and facilitators of implementing a teamlet approach to managing obesity in 3 safety net clinics. Key stakeholder interviews (n = 21) were conducted both during early implementation of practice change and 6 months later. Patient surveys (n = 393) examined obese patient activation and health status. Insufficient program resources and limited patient engagement due to external factors were implementation barriers despite fairly high patient activation. Staff members need time and resources to execute new responsibilities to support obesity management in safety net settings. Because of high turnover, multiple supporters may improve sustainability.
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (Drs AuYoung and Ponce); Division of General Internal Medicine & Health Services Research, Geffen School of Medicine, University of California, Los Angeles (Drs Duru and Mangione); and Division of Health Policy and Management, School of Public Health, University of California, Berkeley (Dr Rodriguez).
Mona
M
AuYoung
O Kenrik
OK
Duru
Ninez A
NA
Ponce
Carol M
CM
Mangione
Hector P
HP
Rodriguez
D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009765:Obesity; D011320:Primary Health Care / Q000458:organization & administration*; D058996:Quality Improvement; D064876:Safety-net Providers; D012648:Self Care / Q000592:standards*; D011795:Surveys and Questionnaires