Obesity services planning framework for interprofessional primary care organizations

P. Brauer, D. Royall, J. Dwyer, A. M. Edwards, T. Hussey, N. Kates, Heidi J. Smith, Ross Kirkconnell
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引用次数: 5

Abstract

Aim We report on a formative project to develop an organization-level planning framework for obesity prevention and management services. Background It is common when developing new services to first develop a logic model outlining expected outcomes and key processes. This can be onerous for single primary care organizations, especially for complex conditions like obesity. Methods The initial draft was developed by the research team, based on results from provider and patient focus groups in one large Family Health Team (FHT) in Ontario. This draft was reviewed and activities prioritized by 20 FHTs using a moderated electronic consensus process. A national panel then reviewed the draft. Findings Providers identified five main target groups: pregnancy to 2, 3–12, 13–18, 18+ years at health risk, and 18+ with complex care needs. Desired outcomes were identified and activities were prioritized under categories: raising awareness (eg, providing information and resources on weight-health), identification and initial management (eg, wellness care), follow-up management (eg, group programs), expanded services (eg, availability of team services), and practice initiatives (eg, interprofessional education). Overall, there was strong support for raising awareness by providing information on the weight-health connection and on community services. There was also strong support for growth assessment in pediatric care. In adults, there was strong support for wellness care/health check visits and episodic care to identify people for interventions, for group programs, and for additional provider education. Conclusions Joint development by different teams proved useful for consensus on outcomes and for ensuring relevancy across practices. While priorities will vary depending on local context, the basic descriptions of care processes were endorsed by reviewers. Key next steps are to trial the use of the framework and for further implementation studies to find optimally effective approaches for obesity prevention and management across the lifespan.
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跨专业初级保健组织的肥胖服务规划框架
目的我们报告了一个形成性的项目,以制定肥胖预防和管理服务的组织级规划框架。在开发新服务时,首先开发一个概述预期结果和关键流程的逻辑模型是很常见的。这对于单一的初级保健机构来说可能是繁重的,特别是对于肥胖等复杂的疾病。方法初稿由研究小组根据安大略省一个大型家庭健康小组(FHT)的提供者和患者焦点小组的结果制定。20个fht使用一种适度的电子协商一致程序审查了该草案,并确定了活动的优先次序。一个国家小组随后审查了该草案。提供者确定了五个主要目标群体:怀孕至2岁、3-12岁、13-18岁、有健康风险的18岁以上和有复杂护理需求的18岁以上。确定了期望的结果,并根据以下类别对活动进行了优先排序:提高认识(例如,提供有关体重健康的信息和资源)、识别和初步管理(例如,健康保健)、后续管理(例如,团体方案)、扩展服务(例如,提供团队服务)和实践倡议(例如,跨专业教育)。总的来说,大力支持通过提供有关体重-健康联系和社区服务的信息来提高认识。在儿科护理中对生长评估也有强有力的支持。在成人中,对健康护理/健康检查访问和偶发护理的强烈支持,以确定干预措施,团体计划和额外的提供者教育的对象。不同团队的联合开发被证明有助于在结果上达成共识,并确保实践之间的相关性。虽然优先事项因当地情况而异,但对护理过程的基本描述得到了审稿人的认可。接下来的关键步骤是尝试使用该框架,并进行进一步的实施研究,以找到在整个生命周期中预防和管理肥胖的最有效方法。
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