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Obesity: Provider Education with a Patient Intervention

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 8 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 - 406 KB].

Eight studies were included in the review.

  • All studies reported patient weight–related outcomes in the desired direction.
    • After 12 months, patients reduced their weight by a median of 2.5 pounds when compared with a control group (5 studies).
    • Studies without a control group showed patients reduced their weight by a median of 11 pounds (3 studies).
  • One study reported provider outcomes and showed that trained providers had greater knowledge on the topic and were significantly more likely to record a patient’s weight and discuss target weight and diet with the client.

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

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 the 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-based 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-level 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-level 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

  • Five studies were randomized controlled trials and 3 used a pre-post design.
  • Provider education varied by who conducted the education, for how long, and on what topics. Patient interventions included education and counseling.
  • Patient characteristics included diabetes, hypertension, and obesity.