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Purpose

This project will compare two training approaches for US Preventive Services Task Force recommended obesity care in Federally Qualified Health Centers (FQHC) across four aims. Aim 1 compares patient-level effectiveness [i.e., patient relative weight change and the proportion of patients who achieve clinically significant weight loss]. Aim 2 compares reach (patient treatment utilization). Aim 3 compares primary care provider (PCP) referrals to USPSTF-recommended care at 12 (adoption) and 24 months (maintenance) and short- and long-term changes in provider obesity care competencies . Aim 4 compares implementation and service costs.

Conditions

Eligibility

Eligible Ages
Over 5 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Criteria

Study Eligibility Criteria - Provider Trainees:

- Provider Trainees must be PCPs, BHPs, RDNs, or CHWs who work at participating
clinics.

- PCPs that are eligible to participate as Provider Trainees can be any of the
following: Medical Doctors (MD), Doctor of Osteopathic Medicine (DO), Physician
Assistants (PA), or Nurse Practitioners (NP). PCPs must see patients in a
primary care setting and be capable of referring patients to IBT and MNT. PCPs
must have already completed their residency (when applicable).

- BHPs that are eligible to participate as Provider Trainees must be at least one
of the following categories (listed with typical credentials): Licensed
Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed
Marriage and Family Therapist (LMFT), Psychologist (PhD/PsyD), Psychiatric
Nurse Practitioner, Psychiatrist (MD).

- RDNs that are eligible to participate as Provider Trainees must be Registered
Dietitians/Registered Dietitian Nutritionists.

- CHWs must work as Community Health Workers, or in functionally similar role,
within participating clinics

Study Eligibility - EHR Patients: Benefit-Eligible Patients from Participating Clinics

- Benefit-Eligible Patients from Participating Clinics can either be youth (ages 5-20)
or adults (ages 21+) and must be recipients of Medicaid, eligible for the MO
Medicaid benefit (i.e., Medicaid recipients with obesity), and have been seen at
participating FQHC clinics.

Exclusion Criteria - Provider Trainees:

- Not at a participating clinic

- PCPs who do not have the ability to refer to IBT or MNT

- Resident Doctors

- A doctor specializing in reproductive health (or related fields)

Exclusion Criteria - Benefit-Eligible Patients from Participating Clinics:

- Patients without obesity

- Patients not on Medicaid

- Youth under the age of 5

- Not a patient at a participating clinic

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Other
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Active Comparator
CMOC 		The Provider Trainees at the Federally Qualified Health Centers (FQHCs) assigned to the Comprehensive Multidisciplinary Obesity Care (CMOC) condition will receive the CMOC Training during the12-month training period (months 0-12) of the trial, followed by a 12-month (month 13-24) sustainability period.
  • Other: Comprehensive Multidisciplinary Obesity Care
    CMOC is an innovative approach to obesity care delivery that leverages policy, clinical and community linkages, and digital technology for scalability. CMOC involves training providers (medical providers, registered dietitians, and behavioral health providers) to deliver guideline-based obesity care for youth and adults with obesity who receive Medicaid. Guidelines-based care involves screening, identification, weight counseling, and referral to intensive behavioral treatment by medical providers, and delivery of multicomponent intensive behavioral treatment by behavioral health providers and registered dietitians.
    Other names:
    • Core+
Active Comparator
IAUC 		The Provider Trainees at the Federally Qualified Health Centers (FQHCs) in the implementation as usual control (IAUC) condition will receive the IAUC Training during the12-month training period (months 0-12) of the trial, followed by a 12-month (month 13-24) sustainability period. Following the 12-month sustainability period, Provider Trainees will be offered the CMOC Training.
  • Other: Comprehensive Multidisciplinary Obesity Care
    CMOC is an innovative approach to obesity care delivery that leverages policy, clinical and community linkages, and digital technology for scalability. CMOC involves training providers (medical providers, registered dietitians, and behavioral health providers) to deliver guideline-based obesity care for youth and adults with obesity who receive Medicaid. Guidelines-based care involves screening, identification, weight counseling, and referral to intensive behavioral treatment by medical providers, and delivery of multicomponent intensive behavioral treatment by behavioral health providers and registered dietitians.
    Other names:
    • Core+
  • Other: Implementation as Usual Control
    The standard of care implemented in FQHCs in the absence of CMOC training.
    Other names:
    • Core

Recruiting Locations

Washington University School of Medicine
St Louis 4407066, Missouri 4398678 63110
Contact:
Aubrie Hampp, MSc
314-662-2005
ahampp@wustl.edu

More Details

Status
Recruiting
Sponsor
Washington University School of Medicine

Study Contact

Aubrie Hampp, MSc
314-662-2005
ahampp@wustl.edu

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.