COVID-19 is a rapidly evolving situation. When working in different community settings, follow CDC guidance External Web Site Icon to help prevent the spread of COVID-19. Visit www.cdc.gov/coronavirus External Web Site Icon for the latest public health information.

Obesity: Multicomponent Provider Interventions

Tabs

What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity prevention and control.

Summary of Results

Interventions for providers with adult patients:

  • Five studies qualified for the review.
  • Various provider behavior outcomes were assessed, from discussions and advice to measurement of physiologic outcomes in patients (3 studies).
    • All studies reported positive changes in the behaviors assessed; two of the papers reported significant changes.
  • Patient outcomes included weight and blood pressure (2 studies).
    • Weight was reduced in both studies (by 4.5 lbs and 2.5 lbs).
    • Blood pressure results were mixed, one study reported a reduction in systolic and diastolic blood pressure and the other study reported an increase in systolic blood pressure.

Interventions for providers with child and adolescent patients:

  • One study qualified for the review.
  • The one study that qualified for this review provided insufficient information to determine effectiveness.

Summary of Economic Evidence

An economic review of this intervention was not conducted because CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

The following outlines evidence gaps from reviews of provider-oriented interventions to prevent and control obesity: provider education, provider feedback, provider reminders, provider education with a client intervention, multicomponent provider interventions, and multicomponent provider interventions with client interventions.

Future studies should measure changes in provider behavior and patient weight-related outcomes. Studies should be conducted over a clinically meaningful duration, report outcomes with statistical precision, and use a study design and sample size that allows sufficient power to detect a meaningful difference. Following are questions that remain to be answered.

Effectiveness on provider outcomes:

  • What effect do education, reminders, and feedback have on providers' knowledge, attitudes, skills, and behavior?
  • Do these interventions have an additional benefit on the provider's own weight?
  • Which characteristics of these interventions contribute to increased or decreased effectiveness?
  • Does the method of delivery to providers matter?
  • What frequency, duration, or format of provider education contributes to increased or decreased effectiveness?
  • Are provider-based interventions more effective at either preventing weight gain, preventing weight re-gain, or promoting weight loss?

Effectiveness on patient outcomes:

  • If the provider interventions change their knowledge, attitudes, and skills, does this have an effect on patient knowledge, attitudes, and skills?
  • Do provider-level interventions have an effect on patient biological outcomes (such as weight-related outcomes, objectively measured)?
  • What are intervention effects on various subgroups/sub-populations?

Implementation and adoption:

  • Are provider-level interventions more effective when integrated within clinical systems than when offered on a referral basis?
  • Do specific potential benefits from an intervention enhance its acceptability? For example, does training providers on obesity counseling assist with other types of counseling?
  • Are there other harms from an intervention, such as taking time away from other tasks that might be more effective?
  • What is the cost effectiveness of these interventions?
  • How broadly applicable is the intervention; to what types of patients does it appeal?
  • What resources (e.g., time, money, staffing, computer capabilities) constrain these interventions?
  • What are the barriers and enabling factors to adoption and implementation of provider-level interventions? In what ways can they be integrated into institutional or other systems-level interventions?
  • Does effectiveness differ based on the level of scale in which interventions are delivered or on type of provider?

Study Characteristics

No content is available for this section.