Evidence map›Paper›PMID 31147378›Full record

ArticleCMAJ open

Changing provider behaviour to increase nurse visits for obesity in family practice: the 5As Team randomized controlled trial.

Denise L Campbell-Scherer, Jodie Asselin, Adedayo M Osunlana, Ayodele A Ogunleye, Sheri Fielding, Robin Anderson, Andrew Cave, Jeffrey A Johnson, Arya M Sharma

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Denise L Campbell-SchererDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta. denise.campbell-scherer@ualberta.ca.
Jodie AsselinDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Adedayo M OsunlanaDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Ayodele A OgunleyeDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Sheri FieldingDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Robin AndersonDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Andrew CaveDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Jeffrey A JohnsonDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
Arya M SharmaDepartment of Family Medicine (Campbell-Scherer, Cave) and Alberta Diabetes Institute (Campbell-Scherer, Johnson, Sharma), University of Alberta, Edmonton, Alta.; Department of Anthropology (Asselin), University of Lethbridge, Lethbridge, Alta.; Department of Medicine (Osunlana, Ogunleye, Sharma), Division of Endocrinology, University of Alberta; Edmonton Southside Primary Care Network (Fielding, Anderson); School of Public Health (Johnson), University of Alberta, Edmonton, Alta.
University of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is increasing recognition that health care professionals often fail to provide meaningful obesity care in routine clinical practice. There is scant information on how to support practice change. The objective of the 5AsT trial was to assess whether a co-created educational intervention would increase the quantity of obesity visits conducted by family practice nurses.

methodsWe conducted a randomized controlled trial with convergent mixed-methods evaluation in a primary care network in Alberta, Canada. The intervention, based on the Theoretical Domains Framework and 5As of Obesity Management, included 12 2-hour interactive educational sessions from November 2013 to April 2014. Twenty-four teams of nurses, mental health workers and dietitians were randomly assigned to receive the intervention or regular training. The primary outcome measure was the rate ratio of nurse visits for adult obesity care to total clinical visits. Qualitative thematic analysis was previously used to identify barriers and facilitators to intervention uptake. In this study, mixed-methods analysis assessed the impact of these factors on individual nurses' outcomes.

resultsThere was no significant increase in visits over the 6-month intervention (rate ratio 1.30, 95% confidence interval [CI] 0.83-2.03) nor the 9-month post-intervention period (rate ratio 1.38, 95% CI 0.87-2.19). However, provider confidence, views of obesity management, role identity and team and patient relationships were found to affect individual nurses' uptake of the intervention.

interpretationAlthough the intervention did not demonstrate a significant increase in nurse visits for obesity care, this study provides insights into health care practitioners' challenges in changing their approach to obesity management. To improve provider capacity to change effectively within their teams, interventions need to foster not only provider knowledge but also confidence.

Identifiers

PMID31147378
PMCPMC6544504
OpenAlexW2946911461

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.