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Multidisciplinary Approach to Obesity Management: A Case Report
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Best practices in the Veterans Health Administration's MOVE! Weight management program
Leila C Kahwati1, Megan A Lewis, Heather Kane
1National Center for Health Promotion and Disease Prevention, Veterans Health Administration, Durham, North Carolina 27705, USA. Leila.kahwati@va.gov
American Journal of Preventive Medicine
|October 21, 2011
Summary
The Veterans Health Administration
Area of Science:
- Health Services Research
- Obesity Management
- Program Implementation Science
Background:
- Obesity presents a significant challenge within the Veterans Health Administration (VHA).
- The VHA's MOVE! Weight Management Program for Veterans has shown variable implementation across facilities.
- Understanding implementation variations is crucial for optimizing veteran health outcomes.
Purpose of the Study:
- To investigate the variability in the implementation of the MOVE! program.
- To identify facility-specific structures, policies, and processes linked to superior patient weight-loss results.
- To inform best practices for VHA weight management initiatives.
Main Methods:
- Qualitative Comparative Analysis (QCA) was employed to systematically compare cases.
- Data were gathered through site interviews, program summary forms, and medical record abstraction from 2009-2010.
- Eleven high-outcome and eleven low-outcome sites were analyzed to identify causal complexity in program success.
Main Results:
- No two facilities exhibited identical implementation patterns.
- A standard curriculum and group care delivery were necessary conditions for larger weight-loss outcomes.
- Four distinct combinations of conditions, including staff involvement and physician champions, were associated with successful program implementation.
Conclusions:
- A standard curriculum delivered via group format is essential for the MOVE! program's success.
- This essential feature alone does not guarantee optimal patient weight-loss outcomes.
- Findings will guide VHA program development and policy to disseminate identified best practices.
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