FIGURE 1 . Training Background of Respondents
ciated with serious comorbidities . Successfully managing obesity consists of individual behavioral changes , medical management , as well as eliminating societal barriers to healthy lifestyle choices . 6 A medical field is now devoted to treating obesity , but specialists in this area are not common . From the data collected , it is evident that health care professionals in WV believe that obesity intervention is part of the scope of primary care practice . Primary care clinicians can help patients navigate through the complex path of managing obesity if they are equipped with the necessary tools .
Healthcare professionals in the state report a need for more obesity medical education . They indicate that they have an adequate foundation in the pathophysiology of obesity and the ability to discuss nutritional / behavioral changes with their patients . Clinicians also reported a strong foundation in knowledge and counseling about food , nutrition , and physical activity . These topics were highly ranked for inclusion in future CME courses . Despite baseline knowledge in these areas being rated relatively high , these topics should be included in an educational intervention . Lifestyle changes are the foundation of obesity treatment , and it is important to engage providers by covering topics of interest . A variety of physical activity and diet plans should be discussed to provide patients with multiple options to fit their life-style needs . Different options are important since socioeconomic status or
Please Specify Your Degree
Other Doctor of Philosophy ( PhD )
Licensed Clinical Psychologist ( LCP )
Licensed Practical Nurse ( LPN ) Registered Nurse ( RN ) Physician Assistant ( PA ) Nurse Practitioner ( NP )
Doctor of Osteopathic Medicine ( DO ) Doctor of Medicine ( MD )
0 5 10 15 20 25 30 35
geographical location could be a barrier for patient adherence . Clinicians reported confidence in motivational interviewing , yet they were interested in learning more and in strategies for discussing obesity with patients . It would be beneficial for a CME program to teach clinicians how to address obesity in an encouraging manner that will motivate patients for lifestyle change .
Knowledge and confidence were rated as lowest in two medical topics : pharmacology associated with obesity and bariatric surgery . Although the level of interest in these areas was lower than others , the majority of respondents were interested in learning about them . Because these topics are important in the treatment of obesity and were rated as relatively low in base knowledge and confidence , future CME courses should address bariatric surgery and pharmacology related to obesity . Patients with obesity tend to have several comorbidities , such as diabetes , cardio vascular disease , depression and hyperlipidemia . Some medications used to address these issues have the adverse side effect of weight gain . Anti-obesity medications are indicated when patients do not lose weight despite lifestyle modifications . Due to the limited number of obesity medicine specialists in the state , it is important that primary care clinicians be educated on these medications and be familiar with optimizing chronic medications to minimize weight gain . 7 Bariatric surgery is an intervention many patients will encounter . As bariatric surgery continues to expand throughout the state , primary care professionals need to strengthen their knowledge about these procedures , including indications for surgery , and when to refer to a specialist . It is important clinicians learn appropriate management of patients before and after surgery to facilitate positive outcomes , as patients may see their primary care clinician more frequently than their bariatric surgeon .
Other proposed topics with less identified interest (< 75 %) could be lower priority for inclusion in the curriculum . These include shared medical appointments , weight management around pregnancy , and medicolegal issues related to treatment of obesity . It is possible that interest in these topics could increase later , when clinicians may be ready to learn more .
This study discovered that respondents preferred to obtain obesity CME through virtual courses using lecture or case scenario formats . Virtual courses would not require travel and would be less disruptive to clinical schedules . Pertaining to a non-CME modality , clinicians agreed WV Project ECHO , a mobile app , and educational websites were effective ways to deliver medical obesity knowledge . Although it is used by primary care practices in WV and was briefly described in the survey , it is possible that responses to the WV Project ECHO option may have been relatively lower because of unfamiliarity with it . WV Project ECHO uses a hub-and-spoke model in which experts conduct virtual clinics with primary care practitioners in rural and under served areas all over the world . It addresses several chronic diseases in the state but does not currently include obesity .
This study has limitations . Sampling was done by convenience and was limited to practices included in the WV PBRN / CORE survey group and those identified by the snowball sampling technique . Although not all primary care practices in the state were included , a variety of rural practices were represented , and this method allowed the study to be conducted quickly and cost efficiently . The survey was only conducted in WV , so although
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