PATHWEIGH Research

PATHWEIGH is a clinical strategy for weight management intended to help primary care practice teams provide the latest evidence-based help to their own patients. The research will help us understand how well it works, in part, based on how much and how patients and providers use it.  Here are some common questions and answers about the research.

What are the overall aims of the research?

The overall objective is to test the effectiveness of PATHWEIGH versus standard of care in all UCHealth primary care clinics. These clinics span diverse settings, patient populations and community contexts. Another part of the overall objective is to examine methods to optimize implementation. 

Specific aims:

1. Evaluate the implementation of PATHWEIGH and determine its effectiveness versus control clinics using standard of care (SOC) on patient weight loss at 6 months (primary) and weight loss maintenance at 12 and 18 months (secondary) for weight-prioritized visits in primary care
2. Identify predictors of patient weight loss and weight loss maintenance using mediator and moderator analysis, including relevant patient, provider and clinic-level variables
3. Examine contextual factors affecting the adoption, implementation and sustainability of PATHWEIGH using the Practical, Robust, Implementation and Sustainability Model (PRISM)
   

PATHWEIGH has the potential to be a scalable, low-cost, pragmatic approach to obesity that could transform weight management. Its innovation lies in its optimization of existing resources. The ultimate success of PATHWEIGH relies on understanding how to implement evidence-based weight management interventions and make them most effective, and then utilized and maintained in practice.  

How is the study designed and evaluated?

To complete these aims, we will utilize a stepped wedge cluster randomized trial. This means all the UCHealth clinics in the study will be randomly assigned to a different start date. Baseline (pre-intervention) data was collected for 12 months prior to any clinic receiving PATHWEIGH.  Year 1 cohort clinics received the PATHWEIGH (weight management) smart set in EPIC and associated trainings and supports beginning March 17, 2021. Cohort 2 will start March 17, 2022, and cohort 3 on March 17, 2023. Patients’ clinical data and data on practice members’ use of PATHWEIGH EPIC smart sets will be gathered until September 16, 2024.

To answer the research questions, different methods will be used. Data collection methods include clinical data (de-identified data from EPIC), surveys of practice members, observations of the clinical implementation of PATHWEIGH, and interviews of selected practice members and patients. To analyze the data, we will be using statistical, qualitative, and mixed methods. 

Who is funding PATHWEIGH?

PATHWEIGH is funded as an R18 study from the National Institutes of Diabetes, Digestive and Kidney Diseases (NIDDK; grant # 1R18DK127003).

Who do I contact about the research?

If you have questions, contact us to get into contact with our study team.  We are here to help and are excited to share what we are doing with you!

For data sharing, please email Drs. Perreault and Holtrop.

Investigators

Leigh Perreault, MD
Co-Principal Investigator

Dr. Perreault is an Associate Professor of Medicine and Epidemiology, as well as the co-Principal Investigator for PATHWEIGH. Her work strives to transform clinical approaches to weight management and type 2 diabetes. She has a robust record of publications in high-impact peer-reviewed journals, as well as a chapter in Diabetes In America, the flagship online book put forward by the National Institutes of Health. Expanding her presence in the field of obesity, Dr. Perreault recently joined the steering committee advising the U.S. Food and Drug Administration on its approval of anti-obesity medication.  Translation of research for the education of patients and health care providers is one of Dr. Perreault’s top priorities, and is readily evidenced by her dedicated patient care, authoring of the obesity section of UpToDate and speaking engagements across the globe. 

Jodi Summers Holtrop, PhD, MCHES
Co-Principal Investigator

Dr. Holtrop is one of the two leaders for the study. She is a Professor in the Department of Family Medicine and also their Vice Chair for Research. She is also a Senior Implementation Scientist and Associate Program Director of the Dissemination and Implementation Science Program at ACCORDS through the University of Colorado School of Medicine. She is considered a national expert in implementation research, research in family medicine/primary care and qualitative and mixed methods. Her main area of research is implementing health promoting interventions in primary care. Dr. Holtrop also holds certification as a master certified health education specialist with expertise in patient behavior change. Dr. Holtrop has worked in family medicine for 23 years and joined CU in 2013.

E. Mark Gritz, PhD

Dr. Gritz is an Associate Professor and Head of the Division of Health Care Policy and Research, the Director of Operations at the Farley Health Policy Center, and the Director of Operations and Economic Analysis Core Lead at ACCORDS. He received his PhD in Economics from Stanford University and has over 30 years of experience in designing and conducting economic analyses and evaluations of innovations to improve the economic outcomes, health, and well-being of economically disadvantaged populations. Many of these projects have involved youth, women from low-income families, veterans, and elderly populations. His current work focuses on healthcare value and its association with socio-economics factors with an eye towards rapidly responding to research and policy analysis needs in Colorado. Dr. Gritz is supporting the economic and sustainability analysis of the PATHWEIGH intervention as a co-Investigator.

Qing Pan, PhD

Dr. Pan is a Professor in the Department of Statistics, a senior biostatistician in the Biostatistics Center at the George Washington University, and Senior Scientist for the Diabetes Prevention Program Outcome Studies and the Statistical and Data Management Center (SDMC) for the Antibacterial Resistance Leadership Group. With a PhD in biostatistics, she brings a strong methodological background. Dr. Pan has many years of experience as lead methodologist/evaluator and co-investigator on numerous federally funded grants focused on research in randomized clinical trials and electronic health records. Particular areas of interest include selection bias, correlated longitudinal and survival processes, interval censored screening data, diagnostic studies, and gene networks based on similarity and connectivity.

Carlos Rodriguez, PhD

Dr. Rodriguez is a statistical data analyst in the Department of Family Medicine at the University of Colorado Anschutz Medical Campus. Dr. Rodriguez has post-doctoral training functional neuroimaging and a PhD in experimental psychology. Dr. Rodriguez brings a unique and interdisciplinary skillset with interests in fetal alcohol spectrum disorders, functional brain connectivity, diversity equity & inclusion, and quantitative research methods.

Peter C. Smith, MD

Dr. Smith is the Assistant Dean for Clinical Affairs and Assistant Medical Director for CU Medicine and oversees 85 medical directors in all subspecialties at the University of Colorado School of Medicine.  He has 20 years of varied clinical practice including inpatient, outpatient, ER, ICU, obstetrics, rural and urban practice and a progression of clinical leadership positions (Medical Director, Director of Quality and Safety, Vice Chair for Quality and Safety, Associate Vice Chair for Clinical Affairs), these experiences have provided him with a broad experience in developing clinical programs, driving innovation and dissemination, and developing high functioning clinical teams. Dr. Smith’s scholarly work has been in the service of a diverse clinical enterprise, creating infrastructure, and conducting research-based on problems and questions derived directly from clinical practice. For the last 5 years, he has been engaged in developing, implementing, disseminating, and evaluating an extensive team-based care transformation of the University of Colorado’s Family, Internal Medicine and Neurology practices.

Caroline K.Tietbohl, PhD

Dr. Tietbohl is an Assistant Professor in the Department of Family Medicine and a Qualitative Methodologist in the ACCORDS Qualitative and Mixed Methods Core. She received her Ph.D. in Sociology from the University of California, Los Angeles and is experienced in using qualitative methods to study implementation, patient engagement, decision-making and health communication. Dr. Tietbohl’s research focuses on how communication shapes health care experiences, especially as it relates to medical decision-making and variations in health care. Dr. Tietbohl supports qualitative data collection and analyses for the PATHWEIGH study, including interviews with practice members and conversation analysis of video-recorded weight prioritized visits.

Additional members of the research team

E. Seth Kramer, DO, MPH

Dr. Kramer has been serving as a primary care physician at the University of Colorado since 2017 and is an Assistant Professor in the Department of Family Medicine. He was the chief resident at Central Maine Medical Center in Lewiston, Maine, where he completed his residency. He obtained his medical degree at the Touro Osteopathic Medicine in Las Vegas, NV, and has a Master’s in Public Health with a focus in epidemiology from the Virginia Commonwealth University in Richmond, VA. His clinical interests include obesity, nutrition, weight management, diabetes care, and preventive care, as well as embracing a holistic approach to primary care. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and Board Certified.

Lauren Tolle, PhD

Dr. Tolle is a Clinical Psychologist, Associate Director for Behavioral Health and Integrated Programs and Assistant Professor with the University of Colorado Department of Family Medicine. She has worked with integrated primary care programs for over 10 years in providing clinical care as well as developing clinical programs to support the health and wellness of diverse populations. Dr. Tolle has a passion for supporting individuals in creating sustainable, healthy lifestyles.

Chase Wesley Raymond, PhD, PhD

Dr. Raymond is an Associate Professor in the Department of Linguistics at the University of Colorado Boulder, where he is a core faculty member in the Culture and Language as Social Practice (CLASP) Program. He also holds a secondary appointment in the Department of Family Medicine at the University of Colorado Anschutz Medical Campus. With PhDs in Linguistics and Sociology from UCLA, Dr. Raymond’s research in the medical arena focuses on clinician-patient communication. For the PATHWEIGH study, he analyzes video data from weight-prioritized consultations, often in consultation with interview data, to examine the impact of PATHWEIGH on clinical discussions about weight. 

Johnny Williams, MPH

Johnny is the Study Manager for PATHWEIGH and a Research Services Senior Professional within the Department of Family Medicine. He is a recent graduate of the Colorado School of Public Health and is a current Doctor of Public Health student in Community and Behavioral Health. His passion is facilitating health equity in all communities as well as helping to reduce the burden of disease due to chronic health conditions. He is an Oklahoma native and completed his undergraduate education at Oklahoma State University.

Lauri Connelly, MS

Lauri is a senior professional research assistant who has worked with the Department of Family Medicine for the past six years. She has a BA in psychology and a MS in occupational therapy. Her clinical interests include health promotion, education, and patient-centered outcomes. She contributes to this effort as a qualitative research assistant by conducting observations, patient and practice member interviews, and qualitative analysis.

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