Scalable and successful patient portal lifestyle coaching training for primary care clinical staff.
Maribel CedilloJesell ZepedaBernadette KiralyMichael FlynnPaulina Larios ElizaldeEmily ZheutlinElizabeth A RuddPolina V KukharevaJorie M ButlerRachel HessKensaku KawamotoPaul A EstabrooksMargaret B ConroyPublished in: Translational behavioral medicine (2024)
Maintaining a healthy weight postintentional weight loss is crucial for preventing chronic health conditions, yet many regain weight postintervention. Electronic health record (EHR) portals offer a promising avenue for weight management interventions, leveraging patient-primary care relationships. Our previous research demonstrated that coaching alongside self-monitoring improves weight maintenance compared to monitoring alone. Integrating weight management into routine clinical practice by training existing staff could enhance scalability and sustainability. However, challenges such as inconsistent staff qualifications and high coach turnover rates could affect intervention effectiveness. Standardizing services, training, and coaching continuity seem crucial for success. To report on developing, testing, and evaluating an EHR-based coaching training program for clinical staff, guided by an implementation tool for the MAINTAIN PRIME study. Conducted across 14 University of Utah primary care sites, we developed, tested, and evaluated a coaching training for clinical staff. Guided by a planning model and the Predisposing, Enabling, and Reinforcing (PER) tool, stakeholders actively participated in planning, ensuring alignment with clinic priorities. All clinical staff were invited to participate voluntarily. Evaluation measures included staff interest, training effectiveness, confidence, and readiness. Data collection utilized REDCap, with survey results analyzed using descriptive statistics. Despite increased clinical workload and reassignments posed by coronavirus disease 2019, we were able to train 39 clinical staff, with 34 successfully coaching patients. Feedback indicated high readiness and positive perceptions of coaching feasibility. Coaches reported satisfaction with training, support, and enjoyed establishing connections with patients. The PER strategies allowed us to implement a well-received training program found effective by primary care coaches.
Keyphrases
- primary care
- weight loss
- electronic health record
- healthcare
- physical activity
- randomized controlled trial
- coronavirus disease
- clinical practice
- body mass index
- weight gain
- bariatric surgery
- ejection fraction
- end stage renal disease
- systematic review
- virtual reality
- newly diagnosed
- metabolic syndrome
- public health
- machine learning
- risk assessment
- mass spectrometry
- general practice
- postmenopausal women
- high resolution
- drug induced
- bone mineral density
- high speed
- clinical evaluation