Better management of weight in general practice - study protocol

Author: 
Nighat Faruqi, Nigel Stocks, Elizabeth Denney-Wilson, Siaw-Teng Liaw, Catherine Spooner, Jane Lloyd, Rachel Laws, Nouhad El-Haddad, Oshana Hermiz, Mark Harris
Publication type: 
Conference presentation
Program: 
Stream 2 Disadvantaged populations
Year: 
2014

Presented at the Australian and New Zealand Obesity Society (ANZOS) Annual Scientific Meeting, 16 - 18 October 2014

This presentation is available here.

Abstract

In 2011–12, 25% of Australian adults were classified as obese (1). While it is prevalent in all Australian population groups, obesity is particularly prevalent in the most disadvantaged socio-economic groups in whom low health literacy is also more prevalent. (2)

This Study evaluates an intervention targeting obese patients with low health literacy attending general practice aiming to improve their health literacy for weight loss and assist them to attend community-based weight loss lifestyle modification programs.

The study involves 10 practices each in Adelaide and Sydney and the design of the study is a cluster randomised trial with practices randomly assigned to intervention or control groups. For eligibility, practices need to have at least one consenting general practitioner (GP) and practice nurse (PN). We aim to recruit 300 patients in each group. Eligibility criteria for patients:

•          aged 40 – 70 years, have low health literacy identified through a validated screening tool, and BMI ≥ 30

•          visited a participating GP at least once in the last 12 months

•           no heart or renal disease, stroke or insulin treated diabetes

•           no past or planned bariatric surgery

•           not treated with weight loss medications.

The intervention involves clinical audit and screening patients for health literacy with practice feedback meetings; interactive training of GPs and PNs; and a PN visit for health check and referral to community-based lifestyle modification weight loss programs with telephone follow up.

Data will be collected from health professional and patient surveys and interviews, clinical audits and GP and PN visits at baseline, 6 and 12 months. The primary outcomes are PN self-reported behaviour and confidence in patient assessment and providing advice and referral; patient self-reported receipt of assessment, advice and referral and attendance at the referral programs; and patient health literacy related to weight loss. 

The study will provide information on the effectiveness of PN navigation support for obese patients with low health literacy in general practice.

  1. ABS (2008) Overweight and obesity in adults, Australia, 2004–05. ABS cat. no 4719.0. Canberra: Australian Bureau of Statistics.
  2. Thomacos, N and Keleher, H. (2009). Health literacy and vulnerable groups: What works? Melbourne: Department of Health Social Science, Monash University.