- Let’s Go! Shorts: Five-minute video vignettes that deliver innovative, evidence-based, obesity curriculum for care team members. These “shorts” will bring new tools and techniques to the health care community to help improve care for patients with obesity. Watch the Let’s Go! Shorts online.
- Let’s Talk About Obesity Care Podcast: A podcast series focused on thought-provoking and informative conversations to support medical providers interested in obesity prevention and treatment hosted by Carrie Gordon, MD. Listen at LetsTalkAboutObesityCare.podbean.com or wherever you listen to podcasts.
Let’s Go! 2022-2023 Educational Programs: A Realist Evaluation
Austin Steward, Kayla Bronzo, Victoria Rogers, Isaac Stickney, Alec Luro, Robert Bing-You
Purpose/Background
Currently 30% of adults in Maine and 13.7% of children ages 10-17 have obesity. Let’s Go’s goal is to address not only health outcomes of obesity, but also the stigma associated with obesity, including its impact on patients’ mental health and clinicians’ unconscious biases.
This project is a Realist evaluation (an educational and philosophical framework where our social world is viewed with real impacts on programs; i.e. what interventions work for who, and why) of the Let’s Go! 2022-2023 educational programs and initiatives. These initiatives included: an ECHO program, a culinary medicine initiative, spaced-repetition recall “games”, and short videos highlighting important topics. Analyzing educational activities is important as Let’s Go! focuses more on healthcare provider education with the rollout of the new AAP obesity guidelines.
Methods/Approach
Qualitative data was collected by conducting semi-structured interviews of clinicians who participated in these recent programs. This data was coded to determine themes and ultimately Contexts, Mechanisms, and Outcomes surrounding obesity education and management. The summary of this evaluation will be additive to the existing quantitative data the Let’s Go! team already collects.
Results
Seven interviews were coded using 50 different codes. From the codes, themes were analyzed, and the following context-mechanism-outcome was observed:
It was seen that lack of organizational support (context) led to lack of appropriate time to dedicate to the activities (mechanism) decreasing the ability to have the full learning and confidence desired (outcome).
Two outcome themes were also identified. Participants reported an improved ability to use appropriate and helpful language with patients, along with an enhanced community of care with other participants.
| Context | Mechanism | Outcomes |
| Busy clinical practice | Protected time to participate in planned educational activity without provider penalties | New knowledge and skills learned. Increased sense of competence [SDT] |
| Active learning format, e.g., in-person conference or virtual group like ECHO | Connecting with peers perceived to be in similar situations | Builds a sense of community-of-practice [SDT] |
| Variety of practice situations | Choice of frequent, spaced connections with different educational material [e.g., videos, expert/peer sessions] [SDT] | New language is used with patients. Changes in practice behavior occurs. |
| Providers’ desires to address obesity and health equity issues | Local leadership support | Sense of confidence and empowerment |
| Desire to learn state-of-the-art treatment approaches | Periodic, virtual programming for practicing providers, e.g., ECHO | Confidence in medication prescribing |
| Strong sense of caring about obesity as an issue, and motivation to learn from experts | Activities where providers can interact safely with experts | Sense of competence as to when to confer with experts [SDT] |
| Providers’ desire to feel a sense of belonging with others interested in obesity management care | Participation in primarily synchronous activities to connect with other both during and after learning-based activities | Sense of belonging within community [SDT] & increased network of peers to discuss patient care issues |
| Desire of just-in-time teaching activities | Periodic short videos [e.g., like the Just in Five Shorts] about varying topics of obesity that can be watched independently and asynchronously [SDT] | Greater confidence in treating of patients and awareness of additional learning materials within the Let’s Go! framework |
SDT = self-determination theory [competence, autonomy, relatedness]
Conclusion
When developing future educational interventions, the context of organizational support is essential for adequate outcomes. Before implementing future educational interventions, programs should address an organization’s support for providers (e.g., protected time).
Self-determination theory is an emerging educational theory which underpins our initial findings including that the content of obesity training should include specific language providers can use with patients and an interventional format which allows providers to form community.