Abstract
BackgroundObesity is one of the most prevalent health problems in western societies. However, it seems not effectively managed in the healthcare system at present. Originating from smoking cessation a tool called the 5As for obesity management has been drafted and adapted by the Canadian Obesity Network (CON) to improve weight counseling and provider-patient-interaction. This paper describes the rationale and design of the INTERACT study. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed specifically at general practitioners (GPs).MethodsThe INTERACT study is a cluster randomized controlled trial aimed at implementing and evaluating an online-tutorial for obesity management based on the 5As approach in cooperating primary health care practices. Effectiveness of the 5As intervention will be evaluated by assessing patients and doctors perspectives on obesity management in primary care before and after the training. GPs in the intervention group will get access to the 5As obesity management online-tutorial while GPs in the control group will be assigned to a waiting list. Outcome measures for patients and GPs will be compared between the intervention group (treatment as usual + training of the GP) and the control group (treatment as usual). Hierarchical regression models will be used to analyze effects over time pre- and post-intervention.DiscussionThe 5As present physicians with a simple mnemonic for patient counseling in the primary care context. While the use of the 5As in weight counseling seems to be associated with improved doctor-patient interaction and motivation to lose weight, intervention studies assessing the effectiveness of a short 5A eLearning tutorial for physicians on secondary outcomes, such as weight development, are lacking.Trial registrationThe study has been registered at the German Clinical Trials Register (DRKS00009241; date of registration: 03.02.2016).
Highlights
Obesity is one of the most prevalent health problems in western societies
Intervention scheme For the present study, we have developed a 30 min online-tutorial based on the 5As framework of obesity management by the Canadian Obesity Network (CON) which covers recommendations on how to discuss weight with the patient (ASK), assess obesity related risks and causes of weight gain (ASSESS), advise on treatment options (ADVISE), agree on weight loss expectations and treatment plan (AGREE) and assist the patient in the ongoing process of losing weight (ASISST)
general practitioner (GP) are usually challenged by heavy workloads and the delivery of health care is bound to tight time constraints
Summary
Obesity is one of the most prevalent health problems in western societies. It seems not effectively managed in the healthcare system at present. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed at general practitioners (GPs). Other research showed that conservational strategies are seen most effective and recommended far more often by health care professionals [14, 15]. Even these strategies seem not consistently discussed with patients. Barriers include negative attitudes towards patients with obesity, a lack of knowledge of the overall pathophysiology of obesity and familiarity with current guidelines on the management of obesity, as well as a lack of self-efficacy in weight counseling [15,16,17]
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