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2005 HSR&D National Meeting Abstract


3034 — Implementation in VHA of NHLBI Guidelines on Identification and Treatment of Overweight/Obesity

Author List:
Kinsinger LS (VA National Center for Prevention)
Harvey RT (VA National Center for Prevention)
Jones KG (VA National Center for Prevention)
Zele V (VA National Center for Prevention)
Orelien JG (VA National Center for Prevention)
Kahwati LC (VA National Center for Prevention)
Straits-Troster KA (VA National Center for Prevention)
Kirkendall D (VA National Center for Prevention)
Burdick MB (VA National Center for Prevention)
Yevich SJ (VA National Center for Prevention)

Objectives:
Overweight/obesity is a major health concern for VHA. In 1998, the National Heart, Lung, and Blood Institute issued guidelines for the identification, evaluation, and treatment of overweight and obesity in adults. These guidelines were implemented through a program called MOVE! (Managing Overweight/obesity for Veterans Everywhere). MOVE! is undergoing 6-month feasibility pilot testing in 17 VHA facilities.

Methods:
Data were available from the first 4 pilot sites (N=70 patients) to complete the 6-month study period. Three patients who had gastric bypass surgery during the study period were excluded from analyses. Pre/post weights and number and type of patient contacts were collected. MOVE! clinical staff (N=24) were surveyed at 3 and 6 months and enrolled patients at 6 months regarding overall satisfaction with the program and whether they would recommend it to others.

Results:
Patients’ mean age was 57.4 years. Mean initial BMI was 39.1 kg/m2 (range 27.3-65.0); initial weight was 262.4 pounds (range 154-403 lbs.). Patients lost on average 6.4 pounds (range 25 lbs. gained – 57 lbs. lost). 79.1% maintained or lost weight. The average number of contacts with MOVE! clinical staff over the 6-month period was 14. Among the 43 patients who attended group sessions, the mean number of sessions attended was 10; among the 46 who received phone calls, the mean number received was 6. Overall staff satisfaction with the program improved from 3 to 6 months: 58.3% were very satisfied/satisfied and 66.7% strongly agreed/agreed with recommending the program to others at 3 months; corresponding results at 6 months were 81.0% and 85.7%. 72.2% of patients reported that the program helped “a lot” or “somewhat.” 94.4% were extremely, very or somewhat satisfied and 90.3% would recommend the program to others.

Implications:
Preliminary results from the first 4 MOVE! pilot sites show that the NHLBI guidelines were successfully implemented in VHA facilities, largely based on telephone counseling and group sessions. Patients lost a modest amount of weight. Overall staff and patient satisfaction was high.

Impacts:
The MOVE! program initially appears to be a successful population-level implementation of evidence-based guidelines. If further pilot results support this early finding, widespread implementation is warranted.


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