Patient perspectives on the integration of an intensive online behavioral weight loss intervention into primary care.

Abstract

OBJECTIVE: To examine patients' perception of how a referral-based online lifestyle intervention contributed to primary care medicine. METHODS: We invited 50 adults to complete a semi-structured interview after a 1-year online behavioral weight loss intervention (average weight change: -4.79 kg). We developed an iterative codebook using content analysis. Two coders independently coded all transcripts (kappa=0.895). We analyzed responses regarding the integration of the program with primary care. RESULTS: Among the 35 participants who completed the interview, 46% described a positive experience between the program and their routine medical care; 14% noted it was fine/OK; 9% reported no effect, 3% were negative, 11% said that the program was unrelated to their medical care, and 14% that the only connection was the referral. Factors such as physician feedback and support, coordination with routine health care, and improved cardiovascular risk factors were cited in support of a positive experience. Physician feedback was reported by 89%, and 80% stated that the program helped them to follow their physician's advice. CONCLUSION: Physician referral to online education and counseling may facilitate the integration of evidence-based behavioral counseling with primary care. PRACTICE IMPLICATIONS: Internet technology may enable improved access to evidence-based counseling for chronic health problems.