Partnership to Reduce Obesity in Community Health Center Patients (SMARTLife Utah)
University of Utah
Summary
The long-term objective of SMARTLife Utah is to increase the reach of existing digital EBIs for obesity among patients of Community Health Centers (CHCs). SMARTLife Utah will be conducted in up to 11 Community Health Center (CHC) systems, consisting of 38 primary care clinics. SMARTLife Utah is a hybrid Type III effectiveness-implementation design, utilizing a pragmatic, multilevel, three-phase Sequential Multiple Assignment Randomized Trial (SMART). SMARTLife Utah leverages ubiquitous health information technology(HIT)/telehealth for both the implementation strategies and Evidence-Based Intervention (EBI) delivery in order to address barriers for engaging in EBIs. Implementation strategies target two different levels to increase the reach of EBIs: 1. a clinic-level HIT implementation strategy that includes enhanced system supports at the point of care; and 2. patient-level implementation strategies that provide repeated opportunities to enroll in EBIs, as well as motivation/practical problem-solving to facilitate enrollment.
Description
Approximately 40% of U.S. adults have obesity (BMI\>30), and excess body weight is associated with at least 13 different cancers and 5% and 11% of cancer cases in men and women, respectively. Evidence-Based Interventions (EBIs) that address excess body weight, physical inactivity, and poor diet are effective in promoting weight loss and reducing cancer risk, but are grossly underutilized. Digital EBI delivery modalities have yielded outcomes comparable to in-person programs. As such, the long-term objective of SMARTLife Utah is to increase the reach of existing digital EBIs for obesity among p…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * 18 years old or older * BMI ≥ 30 * Speak either English or Spanish * Present at the participating clinic * Valid cell phone number in the electronic health record (EHR) * EHR indicates they have not opted out of receiving text messages from the clinic Exclusion Criteria: * Currently pregnant
Interventions
- BehavioralAsk-Advise-Connect (AAC)
A Health Information Technology (HIT) intervention that consists of an Electronic Health Record (EHR)-based point of care assessment of height/weight for BMI (ASK). If BMI ≥ 30, clinic staff are prompted to ADVISE via a standardized script and automatically CONNECT interested patients to the Evidence-Based Interventions (EBIs) through electronic referral.
- BehavioralText Messaging (TM)
Bidirectional text messages, which include a simple response that directly connects individuals to the EBI in a variety of ways (phone, website, or callback from EBI).
- BehavioralConnect Only (CO)
No patient level implementation strategy.
- BehavioralTM-Continued (TM-Cont)
Bidirectional text messages, which include a simple one-touch response that directly connects individuals to the EBI in a variety of ways (phone, website, or callback from EBI). No additional patient-level implementation strategy.
- BehavioralContinued TM plus Motivation And Problem Solving (TM+MAPS)
Text messages plus telephone health coach calls. MAPS is an empirically validated behavioral approach that has been demonstrated to facilitate change, including enrollment with EBIs.
Location
- Huntsman Cancer Institute at the University of UtahSalt Lake City, Utah