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Implementation of a virtual patient-centered weight loss maintenance behavior competency assessment in adults with obesity.

Kevin Brunacini

Published 2019 in Journal of the American Association of Nurse Practitioners

ABSTRACT

BACKGROUND Evidence shows that 95%-98% of individuals who undergo a diet for weight loss purposes will gain back their weight within 5 years. LOCAL PROBLEM No standardized method exists to assess weight loss maintenance (WLM) behavior competencies in patients who lose weight within a telehealth nutritional counseling private practice. Incorporating this assessment can be used to increase patient self-efficacy and predict a patient's likelihood of long-term weight success. METHODS A quality improvement project, implementing four rapid plan-do-study-act cycles, was conducted. Each cycle included tests of change related to team and patient engagement, implementation of a WLM assessment, and an audit adherence. Data were analyzed using run charts to evaluate the impact of interventions on outcomes. INTERVENTIONS The clinical team submitted a weekly WLM competency survey. A patient intake form was completed to identify behavior risks, followed by implementation of a WLM assessment in weekly follow-ups. A team adherence audit was completed and submitted every week. RESULTS Team WLM competency levels increased 32%, averaging 82% at project conclusion. Completion of the patient intake form reached and held at 100% for the entire duration. Team usage of the WLM assessment peaked at 97%, correlating to increased patient behavior competence by 27.5% as the patient advanced. Team adherence gradually increased, peaking at 100%. CONCLUSIONS Patient screening forms and audit logs created a standardized process to collect, deliver, and better coordinate care. The findings suggest that patients who embodied higher behavioral competence will have a greater likelihood of sustaining their weight results and become the successful 2%-5% of weight maintainers.

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