142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

309754
Frequency of primary care visits and weight loss among overweight and obese adult patients at two community health centers

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

James Buszkiewicz, MPH , Division of Prevention and Wellness, Massachusetts Department of Public Health, Boston, MA
Laura Nasuti, MPH , Division of Prevention and Wellness, Massachusetts Department of Public Health, Boston, MA
Andrea Pinzon-Marquardt, MPH , Division of Prevention and Wellness, Massachusetts Department of Public Health, Boston, MA
Patricia Daly, RN MS , Division of Prevention and Wellness, Massachusetts Department of Public Health, Boston, MA
Ellen Hafer, MTS MBA , Massachusetts League of Community Health Centers, Boston, MA
Joanna Kreil, MPH MSW , Massachusetts League of Community Health Centers, Boston, MA
Mark Josephson , Massachusetts League of Community Health Centers, Boston, MA
Bonnie Andrews, MPH, CPH , Office of Statistics and Evaluation, Massachusetts Department of Public Health, Boston, MA
Thomas Land, PhD , Office of the Commissioner, Massachusetts Department of Public Health, Boston, MA
Background: As part of a quality improvement (QI) effort, MDPH examined the association between the number of primary care (PC) visits and a 5% body weight loss among overweight and obese patients at 2 community health centers (CHCs) that were participating in the Community Transformation Grant (CTG) clinical initiative.

Methods: As part of CTG, 2 CHCs provided their electronic medical records (EMR) with 158,030 unique visit records. This analysis was restricted to overweight and obese patients with two or more PC visits during a one-year period (n=10,902). Logistic regression was used to predict the odds of a 5% weight loss or more based on number of PC visits. Final models were adjusted for potential confounders including age, race, preferred language, gender, smoking status, cholesterol (≥240mg), and presence of ICD-9 codes in EMR related to diabetes, hypertension or disorders related to weight loss.

Results: After adjustment, overweight and obese patients showed greater odds of achieving a 5% weight loss with just 3 visits in one year [OR=1.75  (95% CI=1.36 – 2.23)]. Those with 12 or more visits showed the greatest odds of weight loss [OR=5.22 (95% CI= 4.05 – 6.73).

Conclusion: Every contact with a patient can be an opportunity for a weight loss discussion. Even after accounting for the presence of several medical conditions, patients who had more frequent contact with their PC provider were more likely to lose weight. This information can be used in QI work to have providers to use each visit as an opportunity to support weight loss.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Demonstrate the association between the number of primary care visits and clinically significant weight loss Evaluate the ability of EHR data to improve weight loss in a primary care setting Evaluate EHR as a tool to identify disparities within the primary care setting

Keyword(s): Information Technology, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Bonnie Andrews, MPH, is the Deputy Director of the Office of Statistics and Evaluation in the Bureau of Community Health and Prevention at the Massachusetts Department of Public Health. She oversees community-based data collection initiatives for the Bureau, including oversight of data collection and analysis for Mass in Motion, a statewide obesity prevention initiative promoting healthy eating and active living in 52 communities across the state.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.