Closing Gaps in Obesity Diagnosis and Management
Investigating Barriers to Obesity Diagnosis and Management
Erika Cheng
Primary Investigator
Brief description of study
This research seeks to understand barriers to obesity diagnosis and treatment among providers through retrospective chart review, provider surveys, and interviews/focus groups at three IU Health clinics, as well as gather their feedback on a quality improvement initiative called MyWEIGH (Managing Your Weight with Education, Insight, and Guidance for good Health)—an IU Health-based obesity management program that supports patients through remote monitoring, education, and virtual care.
Detailed description of study
The study aims to explore factors contributing to the underdiagnosis of obesity at three clinics by examining provider behavior—specifically, whether obesity is diagnosed when present and how treatment plans are developed. Findings will inform implementation of MyWEIGH.
1. Medical Record Chart Review
We will review approximately 100 patient charts across three IUH ambulatory clinics (Eagle Highlands, East Washington, and Dunlap) to assess care quality, understand practice variation, and identify lapses in standard work (See Medical Record Data Collection Form). MRNs will be received from IUH and stored securely in Teams and REDCap.
2. Logistics
Prior to conducting any research activities with providers (i.e., physicians, nurse practitioners, and physician assistants), our team will schedule times to meet with clinical teams at Dunlap, Eagle Highlands, and East Washington clinics.
3. Provider Survey
We will administer a brief, 10-minute survey to all providers from the three clinics. The survey will assess the provider’s knowledge/attitudes towards obesity, confidence in obesity management, and barriers to providing diagnosis and optimal treatment (See "Provider Survey" in Attachments). The survey will be housed in REDCap and can be accessed via a QR code. The QR code may be accessed via recruitment emails and study flyers (See "Recruiting Emails" and "Recruiting Flyers" in Attachments). The SIS will be presented prior to the start of the survey.
4. 1:1 Interviews & Focus Groups
We will give providers at each clinic the choice of participating in a focus group or 1:1 interviews. Providers will not be able to engage in both activities.
Interview - We will conduct semi-structured qualitative interviews with 9-15 providers to further explore barriers related to obesity diagnosis from the provider's perspective and their thoughts on MyWEIGH (See "Interview & Focus Group Prompts" in Attachments). Interested participants will sign up for an interview time slot and then be emailed the SIS. Interviews will take place via Zoom and will be recorded for analysis. This will be a one-time interview. Providers will be informed of this opportunity via email and after completing the survey (See Interview Recruitment Blurb in Attachments). A QR code can be accessed via recruitment emails and study flyers (See "Email" and "Flyer" in Attachments).
Focus group - this will take place during one of the clinic's scheduled team meetings. These sessions will last 20-30 minutes and will include the same questions as the interview. Providers will be notified of the session and receive the SIS in advance so that they may opt out of participating.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Obesity, Overweight
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Age: 18 years or above
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Gender: All
1. Medical Record Chart Review Adults (18+) who were treated at either Eagle Highlands, East Washington, or Dunlap IUH clinics between January 1, 2023 and December 31, 2024 and who have a BMI ≥ 30.0 and < 40.0.
2. Provider Survey & Interviews/Focus Groups Physicians, nurse practitioners, and physician assistants from Eagle Highlands, East Washington, and/or Dunlap clinics.
This study investigates the barriers to diagnosing and managing obesity in healthcare settings. Obesity is a condition where excess body fat negatively affects a person's health. The purpose of this study is to explore how healthcare providers diagnose obesity and develop treatment plans. The study will take place at three IU Health clinics and will use methods like chart reviews, surveys, and interviews to gather information.
In this study, researchers will review patient charts to assess care quality and identify any gaps in standard procedures. Providers will be asked to complete a survey about their knowledge and attitudes towards obesity. Additionally, some providers will participate in interviews or focus groups to discuss their experiences and thoughts on obesity management. The study aims to use these insights to improve an obesity management program called MyWEIGH.
- Who can participate: Adults aged 18 and older who were treated at Eagle Highlands, East Washington, or Dunlap IUH clinics with a BMI between 30.0 and 40.0 are eligible for the Medical Record Chart Review. Physicians, nurse practitioners, and physician assistants at these clinics can participate in surveys and interviews.
- Study details: Participants will be involved in activities such as completing surveys and participating in interviews or focus groups. Providers will discuss their experiences with obesity diagnosis and management. The study will use this information to improve the MyWEIGH program.
