Combating Obesity at Community Health Centers (COACH)

A Quality Improvement Collaborative for Weight
Management Programs

 

Community health centers seek effective, low-cost strategies to help patients with weight management.  The MidWest Clinicians’ Network partnered with the University of Chicago to test the feasibility of a weight management quality improvement (QI) collaborative. Five health centers enrolled, with health center staff as primary study participants.  Participants attended three learning sessions to build skills in QI planning and implementation, share best practices, and plan for sustainability.  Tailored coaching and co-development of learning session curricula addressed local needs.  Monthly conference calls facilitated updates and sharing experience.  Topics rated most valuable were patient recruitment and retention strategies, QI techniques, evidence-based weight management practices, and motivational interviewing.  Most highly valued components were face-to-face learning sessions, monthly conference calls, and resource sharing. Challenges included difficulty garnering provider support, high staff turnover, and difficulty tracking patient-level data.

CHC Meeting

The COACH pilot successfully demonstrated implementation of a QI collaborative (QIC) in a resource-limited setting to improve weight management programs at community health centers.  The small size of the QIC allowed for extensive tailoring and co-development of the learning session curricula, QI goals, and priorities and also helped maximize the potential benefits of a collaborative approach.  Shared resources and ideas were valued by all of the teams, along with a sense of improved morale and group accountability to drive projects forward despite challenges and competing priorities.  Over time, the QIC experience provided an opportunity for health center staff to learn how to critically look at clinic processes, design interventions, test them and provide support to peers engaged in similar QI efforts.  Two years, however, may not provide sufficient time for clinic staff to fully master, integrate and benefit from new QI skills; longer-term follow-up may reveal more robust trends.  This pilot experience offers practical lessons for health centers seeking to implement QI initiatives, and can serve as a model for larger-scale QICs to address weight management in community health centers.

Principal Investigator: Deborah L. Burnet, MD, MA
Research Team:
Abigail E. Wilkes, MPH
Priya M. John, MPH
Anusha M. Vable, MPH
Amanda Campbell, BA, MidWest Clinicians’ Network, Inc
Loretta Heuer, RN, PhD, FAAN, Midwest Clinicians’ Network, Department of Nursing, North Dakota State University
Cynthia Schaefer, RN, MSN, Midwest Clinicians’ Network, Department of Nursing, University of Evansville
Lisa Vinci, MD, MS, Department of Medicine, University of Chicago
Melinda L. Drum, PhD, Department of Health Studies, University of Chicago
Marshall H. Chin, MD, MPH
Michael T. Quinn, PhD

Funding Source:
University of Chicago Department of Medicine Campus and Community Health Disparities Pilot Research Grants Program