Implementing weight maintenance with existing staff and electronic health record tools in a primary care setting: Baseline results from the MAINTAIN PRIME trial

Molly B Conroy; Maribel Cedillo; Kayla Jordanova; Jesell Zepeda; Bernadette Kiraly; Michael Flynn; Chaorong Wu; Polina V Kukhareva; Jorie M Butler; Rachel Hess; Tom Greene; Kensaku Kawamoto

doi:10.1016/j.cct.2024.107520

Implementing weight maintenance with existing staff and electronic health record tools in a primary care setting: Baseline results from the MAINTAIN PRIME trial

Contemp Clin Trials. 2024 Mar 28:141:107520. doi: 10.1016/j.cct.2024.107520. Online ahead of print.

Authors

Affiliations

¹ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Population Health Science, University of Utah, Salt Lake City, UT, USA. Electronic address: molly.conroy@hsc.utah.edu.
² Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: maribel.cedillo@hsc.utah.edu.
³ Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: u6036129@umail.utah.edu.
⁴ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: Jesell.Zepeda@hsc.utah.edu.
⁵ Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: Bernadette.Kiraly@hsc.utah.edu.
⁶ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Pediatrics, University of Utah, Salt Lake City, UT, USA; Community Physicians Group, University of Utah Health, Salt Lake City, UT, USA. Electronic address: michael.flynn@hsc.utah.edu.
⁷ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. Electronic address: u6039863@utah.edu.
⁸ Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA. Electronic address: polina.kukhareva@utah.edu.
⁹ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA; Geriatrics Research and Education Center (GRECC) George E. Wahlen, Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA. Electronic address: jorie.butler@hsc.utah.edu.
¹⁰ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Population Health Science, University of Utah, Salt Lake City, UT, USA. Electronic address: rachel.hess@hsc.utah.edu.
¹¹ Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Population Health Science, University of Utah, Salt Lake City, UT, USA. Electronic address: tom.greene@hsc.utah.edu.
¹² Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA. Electronic address: kensaku.kawamoto@utah.edu.

PMID: 38552870
DOI: 10.1016/j.cct.2024.107520

Abstract

Background: There is need for interventions that can assist with long-term maintenance of healthy body weight and be sustainably integrated into existing primary care teams. The goal of MAINTAIN PRIME (Promoting Real (World) IMplEmentation) is to evaluate whether a successful electronic health record (EHR)-based weight maintenance intervention can be adapted to a new clinical setting with primary care staff serving as coaches.

Methods: EHR tools include tracking tools, standardized surveys, and standardized "SmartPhrases" for coaching. Inclusion criteria were age 18-75 years, voluntary 5% weight loss in the past 2 years with prior BMI ≥ 25 kg/m², and no bariatric procedures in past 2 years. Participants were randomized 1:1 to tailored online coaching with EHR tracking tools (coaching) or EHR tracking tools alone (tracking).

Results: We screened 405 individuals between September 2021 and April 2023; 269 participants enrolled (134 coaching; 135 tracking). The most common reason for not enrolling was ineligibility (55%). At baseline, participants were 50.3 (SD 15.02) years old, 66.4% female, and 84% White; 83.7% reported moderate physical activity. Average weight and BMI at baseline were 205.0 (SD 48.9) lbs. and 33.2 (6.8) kg/m², respectively. Participants lost an average of 10.7% (SD 5.2) of their body weight before enrolling. We recruited 39 primary care coaches over the same period. Conclusion The study successfully identified and recruited primary care patients with recent intentional weight loss for participation in a weight maintenance program that uses EHR-based tools. We also successfully recruited and trained primary care staff as coaches.

Keywords: Coaching; Health information technology; Implementation; Primary care; Randomized clinical trial; Weight management.