Adherence
Implementing enhanced nurse care manager (NCM) training and digital monitoring tools in primary care significantly increases patient enrollment in online behavioral weight loss programs compared to basic implementation, without compromising weight loss outcomes or program acceptability.
For primary care systems, simply offering an online weight loss program is not enough. You must invest in 'Enhanced' implementation strategies: train your care managers in motivational interviewing, provide them with a dashboard that flags non-adhering patients, and encourage proactive follow-up calls. This approach significantly increases the number of patients who start the program, which is the biggest hurdle in obesity treatment, even if it doesn't change the weight loss results for those who do start.
NCMs in Enhanced enrolled more patients (N = 490) than in Basic (N = 164)... Although the proportion of patients who completed RxWL and mean weight loss did not differ by condition, different enrollment rates resulted in the Enhanced condition engaging more patients.
Why this rating
Hybrid type 2 implementation-effectiveness trial with a large sample size (N=654 enrolled) and pragmatic design, though lack of fidelity monitoring for NCM adherence is a limitation.
Source
Pragmatic online obesity treatment in primary care: a hybrid randomized clinical trial of implementation strategies
Carly M. Goldstein et al. · npj Cardiovascular Health · 2024
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