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Abstract
BackgroundAn integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential.MethodsThe trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework.ResultsAt baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance.ConclusionsRE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.
Highlights
Obesity and depression are highly prevalent conditions [1] that commonly present together among patients in primary care, typically they are treated separately [2]
Participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions
The potential public health impact of these comorbid conditions is great given their association with prevalent chronic illnesses such as type 2 diabetes and cardiovascular disease, which are leading causes of death in the United States [5]
Summary
Obesity and depression are highly prevalent conditions [1] that commonly present together among patients in primary care, typically they are treated separately [2]. The potential public health impact of these comorbid conditions is great given their association with prevalent chronic illnesses such as type 2 diabetes and cardiovascular disease, which are leading causes of death in the United States [5]. To address the needs of patients with comorbid obesity and depression, a recent pragmatic clinical trial established the clinical effectiveness of treating both conditions together with an integrated collaborative care intervention called I-CARE (Integrated Coaching for Better Mood and Weight) [6]. An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential
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