Assessment of factors influencing participation and outcomes in a weight management program

The Clinic Community Intervention Program (CCIP) uses Wagner's Chronic Care Model (CCM) as a framework for integrating a clinical care model that improves provider identification and management of obesity with support that is grounded in lifestyle modification. The CCIP target population has a BMI of 30 or greater, is aged 18-55, and is from inner city neighborhoods that are predominantly African American and Hispanic.

The aim of this mixed methods study was to identify factors that impact a person's decision to participate in the CCIP. Focus groups and retrospective chart reviews were conducted on participants and non-participants individuals referred by their PCPs.

Data collected included: weight, height, BMI, blood pressure, blood glucose, triglyceride, LDL, HDL, cholesterol, and a history of diabetes, heart disease or other chronic conditions. Descriptive data and cross tabulations were used to explore the factors associated with a patient's decision to join a weight management class. For the qualitative analysis, focus groups were conducted in the two groups.

Common themes for those participating were presence of a physical limitation, particularly joint pain, a desire for “healthy aging”, maintenance of self esteem, and “being there for the family”. Non-participants emphasized the time demands of “care-giving”, generalized stress, and just not being ready.

Chart review found significant differences in quality of life issues, joint pain and anxiety, in participants compared to non-participants. There were no differences in physiological measurements.

Programs dealing with obese individuals should address “quality of life” issues to motivate participation in a weight management program.