Protocol for the Rural Engagement in Primary Care for Optimizing Weight Reduction (RE-POWER) Trial: Comparing three obesity treatment models in rural primary care

Contemporary Clinical Trials
Christie A BefortAndjela Drincic

Abstract

Obesity disproportionately affects rural residents in the United States, and primary care has the potential to fill a major gap in the provision of weight management services for rural communities. The objective of this cluster-randomized pragmatic trial is to evaluate the comparative effectiveness of three obesity treatment models in rural primary care: the Intensive Behavior Therapy fee-for-service (FFS) model reimbursed by Medicare, a team-based model that recognizes the patient-centered medical home (PCMH) as a preferred delivery approach, and the centralized disease management (DM) model, in which phone-based counseling is provided outside of the primary care practice. We hypothesize that the PCMH and DM treatments will be more effective than FFS in reducing weight at 24 months. Thirty-six practices from the rural Midwestern U.S. are randomized to deliver one of the three interventions to 40 patients (N=1440) age 20 to 75 with a BMI 30-45 kg/m(2). In the FFS arm, primary care providers and their personnel counsel patients to follow evidence-based weight loss guidelines using the Medicare-designated treatment schedule. In the PCMH arm, patients receive a comprehensive weight management intervention delivered locally by prac...Continue Reading

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Citations

Jan 12, 2019·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·Gwenndolyn C PorterPaul A Estabrooks
May 17, 2019·Translational Behavioral Medicine·Marsha B NovickLeslie R Walker-Harding
Nov 12, 2020·American Journal of Men's Health·Stephanie E PuntChristie A Befort
Feb 7, 2018·Contemporary Clinical Trials·Peter T KatzmarzykBenjamin Springgate
Apr 13, 2021·Obesity Science & Practice·Cody L GoesslJeffrey J VanWormer

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