Examining the use of mhealth technology for weight management: A hybrid effectiveness-implementation trial in family medicine.

Overweight and obesity are prevalent and problematic conditions in the United States and worldwide, and effective weight management interventions are underutilized. Efforts to improve weight management practices have focused almost exclusively on changing physician behavior, without considering the larger healthcare context or the reciprocal patient-physician relationship. A new dissertation study explored the possibility of leveraging technology to improve the implementation of weight management clinical practice guidelines and increase patient-physician weight management discussions. 100 patients of five family medicine physicians were randomly assigned to either complete a weight management mobile application (app) prior to their primary care visit (app condition), or to undergo their primary care visit as usual (control condition). Findings suggested that patients largely viewed the app as an acceptable use of their time in the waiting room and they were able to complete the app with moderate fidelity prior to meeting with their physicians. Consistent with hypotheses, patients in the app condition were statistically more likely to initiate discussions about weight status than patients in the control group. However, contrary to hypotheses, these discussions did not occur at a statistically higher rate in the app condition than in the control condition. Overall weight status conversations were low relative to patient need, occurring in 42.7% of total visits, though 82.5% of the total sample was classified as overweight or obese. Also contrary to hypotheses, patients in the app condition did not demonstrate statistically improved BMI at follow-up than the control condition. Strengths, limitations, and directions for future research are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

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