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Obesity: Multicomponent Provider Interventions


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 6 studies (search period 1966 to June 30, 2007).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity prevention and control.

Summary of Results

Detailed results from the systematic review are available in the CPSTF finding pdf icon [PDF - 129 KB].

Six studies were included in the review.

Providers for Adult populations (5 studies)

  • Three studies reported small but significant findings in the favorable direction for the following provider behaviors:
    • Weight loss: advising and discussing with patients
    • Weight: measuring BMI (body mass index) or weight itself
    • Other clinical indicators: checking other indicators, such as blood pressure
  • Two studies reported patient outcomes.
    • Patients lost an average of 4.5 and 2.5 pounds, respectively.
    • Blood pressure results were inconsistent.

Providers for Children (1 study)

  • There were significant increases in charting BMI-for-age percentile.
  • No patient-level outcomes were reported.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

Effectiveness on provider outcomes:

  • What effect do interventions have on providers' knowledge, attitudes, skills, and behavior?
  • Do interventions have an additional benefit on a provider's own weight?
  • Which characteristics of the interventions contribute to increased or decreased effectiveness?
  • Do different methods of delivery to providers produce different results?
  • What frequency, duration, or format of provider education contributes to increased or decreased effectiveness?
  • Are provider interventions more effective at preventing weight gain, preventing weight re-gain, or promoting weight loss?

Effectiveness on patient outcomes:

  • If the provider interventions change their knowledge, attitudes, and skills, does this have an effect on patient knowledge, attitudes, and skills?
  • Do provider interventions have an effect on patient biological outcomes (such as weight-related outcomes, objectively measured)?
  • Do intervention effects vary when delivered to subgroups or sub-populations?

Implementation and adoption:

  • Are provider interventions more effective when used within clinical systems than when patients are referred to providers outside the system?
  • Do specific benefits of an intervention enhance its acceptability? For example, does training providers on obesity counseling assist with other types of counseling?
  • Are there other harms from an intervention, such as taking provider time away from other tasks that might be more effective?
  • What is the cost effectiveness of these interventions?
  • How broadly applicable is the intervention; to what types of patients does it apply?
  • What resources (e.g., time, money, staffing, computer capabilities) constrain these interventions?
  • In what ways can interventions be integrated into institutional or other system-level interventions?
  • Does effectiveness differ by the type of provider?
  • Does the level of scale affect whether interventions work?

Study Characteristics

  • Four of the adult studies were randomized controlled trials; 1 study used a pre-post design.
  • One study with children was a 3-month pre-post design to improve physician management of overweight children.
  • Core intervention elements included education, feedback, reminders, and other interventions.
  • Adult patients had diabetes, hypertension, or obesity.