Applying the Pragmatic-Explanatory Continuum Indicator Summary Model in a Primary Care-Based Lifestyle Intervention Trial.

Abstract

The majority of adults in the U.S. can be classified as overweight or obese (68%), putting them at risk for Type 2 diabetes, cardiovascular diseases, and other adverse health outcomes. The U.S. Preventive Services Task Force recommends that providers offer or refer obese adults to intensive, multicomponent lifestyle interventions. However, there is a critical need for interventions that have been shown to be pragmatic and effective among diverse populations, scalable across different clinical settings and systems, and sustainable over time. The Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) tool can be used to assess the degree to which trials of behavioral lifestyle interventions provide evidence to support this need. We used our recently completed trial, Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE), as a case study and assessed the domains of PRECIS to explore the degree to which we felt it achieved its intended pragmatic design (completed in December 2014). Overall, the systematic assessment using the PRECIS tool revealed that the E-LITE trial design was very pragmatic in nature. Its results and the subsequent adoption of the intervention into actual practice also suggest high potential for implementation of primary care interventions.