Cohort Update: Healthy Lifestyles and Weight

Maintaining a healthy lifestyle and weight can provide a wide range of health benefits, while having obesity or overweight puts individuals at increased risk for serious conditions such as heart disease, stroke, type 2 diabetes, and certain types of cancer. Unfortunately, more than one third of adults in the U.S. are obese or have a body mass index of 30 or higher.

To address this health concern, PaTH created the Healthy Lifestyles and Weight cohort, which aims to understand how body weight impacts health, and to help people successfully manage their weight and develop healthier lifestyles. The cohort works with patients and care providers to learn what particular information would be helpful to them as they make decisions about preventive health and weight management.

"Understanding how our health care system can help patients improve health behaviors is an important area for research to prevent and treat chronic diseases like diabetes, obesity, and heart disease," says Wendy Bennett, M.D., M.P.H. Dr. Bennett is a PaTH Clinical Champion and an Associate Professor of Medicine at Johns Hopkins University who works with the Healthy Lifestyles and Weight cohort.

To better understand patients’ health behaviors and how they interact with the health care system, researchers sent patients surveys that addressed topics like their quality of life, diet, exercise behaviors, and use of health care. Sharon J. Herring, M.D., M.P.H., a PaTH Clinical Champion and an Associate Professor of Medicine at Temple University, says the survey responses are "a first step towards using real-world data to help understand the health concerns of patients." Baseline surveys were completed by 1,311 participants during the summer of 2015. Follow-up surveys were sent six and 12 months later, with 795 and 748 patients participating, respectively. Researchers finished collecting surveys in fall 2016.

Stakeholders in the cohort advised researchers on the content of these surveys as well as on how they should be administered. "When designing studies, it’s important for researchers to consider the willingness of patients with obesity to engage in research," says Jennifer Kraschnewski, M.D., M.P.H., a PaTH Clinical Champion and an Associate Professor of Medicine at Penn State University. "Having the patient voice represented is a critical component to ensuring research is relevant to what patients care about."

Dr. Herring notes that researchers in the cohort are currently working on multiple papers and grant proposals. One paper assesses whether women who undergo bariatric surgery, and experience accompanying weight loss, utilize preventive health screenings more in the 1-3 years following their surgery. Another characterizes best practices in study recruitment and enrollment.

PaTH’s Healthy Lifestyles and Weight researchers have also developed grant proposals that leverage their work with PCORnet. For example, Dr. Kraschnewski has received funds from PCORI for a project using PaTH data to evaluate whether Medicare reimbursement for obesity counseling improves health in people at risk or with type 2 diabetes. Likewise, Drs. Jeanne Clark and Wendy Bennett were recently notified that they will receive funds for an Obesity Center within the Strategically Funded Obesity Research Network from the American Heart Association, to develop several projects addressing the role of time-restricted feeding on obesity. One of these projects will be a PaTH-affiliated clinical study using mobile technology for efficient, momentary assessments of day-to-day eating behaviors in primary care to assess whether different patterns of eating and sleep affect weight over time.

Dr. Bennett says she hopes the work of the Healthy Lifestyles and Weight cohort will benefit both patients’ health and their relationships with care providers.

"We can improve doctor-patient communication around health behaviors and develop and test strategies to improve obesity care and control in clinic."

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