title: Patient factors associated with initiation of behavioral weight loss treatment: a prospective observational study in an integrated care setting.
abstract: Low enrollment in behavioral weight loss treatments limits their impact. We aimed to identify factors associated with treatment initiation. The participants were outpatients (n = 198) at Veterans Affairs (VA) healthcare facilities who were referred to a free VA-based behavioral weight loss treatment. Participants were assessed on psychosocial factors potentially relevant to treatment initiation. Subsequent treatment initiation was determined via medical record review. Study participants were 77 % male, 60 % African American, and 54 % initiated treatment. In multivariable analyses, treatment initiation was associated with being single, higher anxiety, and patients' perceptions that referring provider supported their weight autonomy. Endorsement of treatment barriers was not associated with treatment initiation. Treatments offering in-person sessions and mood management components were rated as more preferred. Initiation of behavioral weight loss treatments may increase if patients believe that providers respect their weight control autonomy and if healthcare organizations offer treatments that match patients' preferences.
authors: Department of Psychiatry and Behavioral Science & Durham VA Center for Health Services Research and Development, Duke University Medical Center, Box 3862, Durham, NC, 27710, USA. megan.mcvay@duke.edu.
authors: Megan A
authors: MA
authors: McVay
authors: Department of Medicine, Division of General Internal Medicine & Durham VA Center for Health Services Research, Duke University Medical Center, 2301 Erwin Road, Durham, NC, 27710, USA.
authors: William S
authors: WS
authors: Yancy
authors: VA Loma Linda Health System, 11201 Benton Street, Loma Linda, CA, 92357, USA.
authors: Christine N
authors: CN
authors: Scott
authors: Salt Lake City VA, 500 Foothill Blvd, Salt Lake City, UT, 84148, USA.
authors: Lindsay
authors: L
authors: Wilson-Barlow
authors: Durham VA Center for Health Services Research & Development, 508 Fulton St. (152), Durham, NC, 27705, USA.
authors: Sandra
authors: S
authors: Woolson
authors: Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA.
authors: W Clint
authors: WC
authors: McSherry
authors: Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA.
authors: Sandra
authors: S
authors: Allen
authors: Durham VA Center for Health Services Research & Development & Duke University Medical Center, Department of Medicine, Division of General Internal Medicine, 2301 Erwin Road, Durham, NC, 27710, USA.
authors: Corrine I
authors: CI
authors: Voils
mesh_terms: D000328:Adult; D001741:Black or African American; D001521:Behavior Therapy / Q000379:methods*; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011446:Prospective Studies; D011584:Psychology; D014481:United States; D014728:Veterans / Q000523:psychology*; D015431:Weight Loss / Q000502:physiology*; D061217:Weight Reduction Programs / Q000379:methods*
keywords: Behavioral weight loss treatment; Provider communication; Treatment engagement