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. 2018 Jun 23;19(1):97.
doi: 10.1186/s12875-018-0785-7.

Five A's counseling in weight management of obese patients in primary care: a cluster-randomized controlled trial (INTERACT)

Franziska D Welzel  1   2 , Janine Stein  3 , Alexander Pabst  3 , Melanie Luppa  3 , Anette Kersting  4   5 , Matthias Blüher  4 , Claudia Luck-Sikorski  3   4   6 , Hans-Helmut König  7 , Steffi G Riedel-Heller  3   8
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Five A's counseling in weight management of obese patients in primary care: a cluster-randomized controlled trial (INTERACT)

Franziska D Welzel et al. BMC Fam Pract. .

Abstract

Background: Obesity is one of the most prevalent health problems in western societies. However, it seems not effectively managed in the healthcare system at present. Originating from smoking cessation a tool called the 5As for obesity management has been drafted and adapted by the Canadian Obesity Network (CON) to improve weight counseling and provider-patient-interaction. This paper describes the rationale and design of the INTERACT study. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed specifically at general practitioners (GPs).

Methods: The INTERACT study is a cluster randomized controlled trial aimed at implementing and evaluating an online-tutorial for obesity management based on the 5As approach in cooperating primary health care practices. Effectiveness of the 5As intervention will be evaluated by assessing patients and doctors perspectives on obesity management in primary care before and after the training. GPs in the intervention group will get access to the 5As obesity management online-tutorial while GPs in the control group will be assigned to a waiting list. Outcome measures for patients and GPs will be compared between the intervention group (treatment as usual + training of the GP) and the control group (treatment as usual). Hierarchical regression models will be used to analyze effects over time pre- and post-intervention.

Discussion: The 5As present physicians with a simple mnemonic for patient counseling in the primary care context. While the use of the 5As in weight counseling seems to be associated with improved doctor-patient interaction and motivation to lose weight, intervention studies assessing the effectiveness of a short 5A eLearning tutorial for physicians on secondary outcomes, such as weight development, are lacking.

Trial registration: The study has been registered at the German Clinical Trials Register ( DRKS00009241 ; date of registration: 03.02.2016).

Keywords: 5As counseling; Doctor-patient-interaction; Obesity; Primary care; cRCT.

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Conflict of interest statement

Ethics approval and consent to participate

The ethics committee of the University of Leipzig has approved this study (AZ.: 248–15-13,072,015). The study will be performed in accordance with the Guidelines for Good Clinical Practice (ICH-GCP), the Declaration of Helsinki in its latest version and international and local laws. Written informed consent was obtained from all participants prior to enrolment in the study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overview of the 5As for obesity management [25]
Fig. 2
Fig. 2
Cluster-randomized trial intervention scheme
See this image and copyright information in PMC

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