MRWeight: Medical Residents Learning Weight Management Counseling Skills -- A Multi-Modal, Technology-Assisted, Spaced Education Program

MRWeight：住院医生学习体重管理咨询技能——多模式、技术辅助、间隔教育计划

• 批准号: 10561356
• 负责人: JUDITH K OCKENE
• 金额: $ 86.69万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-02 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10561356
• 关键词: Address; Adoption; Adult; Advocate; Affect; American; American Heart Association; Assessment tool; Behavior; Caring; Characteristics; Chronic Disease; Clinical; Communication; Comparison arm; Complex; Counseling; Diet; Dissemination and Implementation; Education; Educational Curriculum; Educational process of instructing; Effectiveness of Interventions; Electronic Mail; Epidemic; Evaluation; Feedback; Future; Guidelines; Health; Heart Diseases; Intention; Internal Medicine; Intervention; Knowledge; Learning; Matched Group; Mediating; Mediator; Medical; Medical Education; Medical Examiners; Methods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obesity Epidemic; Obesity associated disease; Outcome; Overweight; Patient Care; Patient Self-Report; Patients; Physical activity; Physicians; Pilot Projects; Play; Post Graduate Year; Primary Care; Process; Process Measure; Program Appropriateness; Psychological reinforcement; Public Health; Publishing; Randomized, Controlled Trials; Recommendation; Recording of previous events; Reporting; Residencies; Risk; Self-Examination; Site; Stroke; Technology; Technology Assessment; Testing; Text; Time; Training; Training Programs; United States; United States National Institutes of Health; Visit; Weight; Weight maintenance regimen; analog; clinical implementation; clinical practice; cohort; comparison intervention; crowdsourcing; design; effectiveness evaluation; evidence base; follow-up; gateway course; innovative technologies; intervention effect; medical schools; multimodality; novel; obesity prevention; obesity treatment; patient oriented; primary care setting; primary care visit; programs; randomized trial; response; sex; skill acquisition; skills; social cognitive theory; uptake

7. Project Summary/Abstract Overweight and obesity have reached epidemic proportions in the United States, proving to be a very difficult health challenge for both patients and the physicians who care for them. Excess weight is a major contributor to heart disease, stroke, and type 2 diabetes. Addressing overweight and obesity in clinical visits is critical to treating and preventing these obesity-associated diseases. However, Weight Management Counseling (WMC) uptake is low, and physicians report lack of training as a critical barrier to WMC. Residency training is a crucial time to influence physicians' current and future practice, yet there is no evidence-supported WMC curriculum for residents. Informed by two pilot studies, MRWeight will use spaced-education to train residents to deliver WMC using the 5As framework (Ask, Advise, Assess, Assist, Arrange) and patient-centered counseling. As such, MRWeight will be delivered in short segments and spaced over 12 months using four components: didactic session 1 – a discussion of WMC foundational concepts; 3Ps program (Prepare, Practice, Process) – an email program using the Video-based Communication Assessment (VCA) to facilitate practice of challenging cases; didactic session 2 – a discussion of key barriers to practicing WMC; and email reinforcement of concepts covered in the preceding components. Each component, guided by Social Cognitive Theory (SCT), is designed to build on and reinforce the training provided by the other components. Using a pair-matched group randomized controlled trial (RCT) including 8 Internal Medicine residency programs, we will test the MRWeight intervention with 3 cohorts of postgraduate year 1 residents followed for 18 months. Comparison arm residents will be emailed the PowerPoint of a foundational course on WMC, but unlike those in the Intervention, comparison sites will not include the didactic sessions or the 3Ps program. Our aims are: Aim 1 will evaluate the effectiveness of the MRWeight Intervention for increasing residents' WMC skills at 12 months; Aim 2 will evaluate residents' self- reported adoption of WMC skills in their encounters with patients in clinical practice at 18 months; Aim 3 will explore possible mechanisms (mediators) and moderators of the intervention's effect on Aim 1 and 2 outcomes (residents' WMC skills and adoption). The study will be the first large trial to test a curriculum that has been integrated into Internal Medicine residency programs for teaching WMC skills. The multi-PIs (Drs. Ockene and Sadasivam) will build on 36-years of successfully conducting large, randomized trials to evaluate training programs, including those that taught the 5As and patient-centered counseling for WMC, in 18 medical schools, 10 residency sites, and 10 primary care settings. This study is timely, given public health momentum strongly advocating for physician training and involvement in WMC and the dissemination and implementation of clinical guidelines for obesity treatment.

7。项目摘要/摘要 在美国，超重和肥胖已经达到了流行比例，这是一个非常困难的 患者和关心他们的医生的健康挑战。体重过多是主要的贡献者 心脏病，中风和2型糖尿病。解决临床访问中的超重和肥胖症对 治疗和预防这些与肥胖相关的疾病。但是，体重管理咨询（WMC） 摄取量很低，医生报告缺乏培训是WMC的关键障碍。居住培训至关重要 是时候影响医生当前和未来的实践了，但是没有证据支持的WMC课程 居民。由两项试点研究得知，MRWeight将使用间隔教育来培训居民提供WMC 使用5AS框架（询问，建议，评估，协助，安排）和以患者为中心的咨询。像这样， MrWeight将在短段中交付，并使用四个组成部分进行12个月的间隔：Didactic 会议1 - 关于WMC基础概念的讨论； 3PS程序（准备，练习，过程） - 电子邮件 使用基于视频的沟通评估（VCA）的计划来促进挑战案例的实践； 教学会议2 - 关于实践WMC的关键障碍的讨论；以及涵盖概念的电子邮件加强 在前面的组件中。在社会认知理论（SCT）的指导下，每个组成部分旨在建立 并加强其他组件提供的培训。使用成对匹配的组随机 对照试验（RCT），包括8个内科居住计划，我们将测试MR Wauights干预 有3个研究生1年级的居民随后持续了18个月。比较手臂居民将通过电子邮件发送 WMC基础课程的PowerPoint，但与干预中的Powerpoint不同，比较站点不会 包括教学会话或3PS程序。我们的目标是：AIM 1将评估 为提高居民在12个月时提高居民的WMC技能的MR Weawight干预； AIM 2将评估居民的自我 据报道，在18个月的临床实践中，在与患者的相遇中采用了WMC技能；目标3意志 探索干预措施对目标1和2结果的影响的可能机制（介体）和主持人 （居民的WMC技能和采用）。这项研究将是测试课程的首次大型试验 集成到内科居住计划中，用于教授WMC技能。多派（Dr. Ockene和 Sadasivam）将建立在36年的成功进行大型随机试验以评估培训的基础上 计划，包括在18个医学院中教授5A和以患者为中心的WMC咨询的计划， 10个居住地和10个初级保健环境。这项研究是及时的，鉴于公共卫生的势头强烈 主张体育锻炼和参与WMC以及临床的传播和实施 肥胖治疗指南。