The successful partnership between researchers at West Virginia University and the Public Employees Insurance Agency in evaluation and improvement of a weight management program is being highlighted by the U.S. Centers for Disease Control and Prevention as a exemplary effort.
The peer-reviewed abstract in the May 2010 edition of the CDC’s electronic journal, Preventing Chronic Disease, “sheds a positive light on efforts to fight obesity in West Virginia and improve people’s health,” said Christiaan G. Abildso, PhD, MPH, from the College of Physical Activites and Sports Sciences, who participated in the study and wrote the article.
“It took trust, confidence and encouragement in the original research efforts to allow our efforts to succeed,” Abildso said. “PEIA took our suggestions, the results of the study, and used them to benefit the state. We’re thankful for their support and openness to work with us.”
While the peer-reviewed abstract is perfect reading for those keen on statistical analyses and research methods, the real story lies in counties scattered throughout West Virginia and how PEIA took the lead in fighting obesity in the state.
PEIA offers medical-related benefits to all active employees of the State of West Virginia, various related state agencies and local governments. Included under the umbrella of numerous care management options, is a comprehensive weight management program at approved sites throughout the state.
“Since 2004, the PEIA weight management program has been a work in progress. When we initiated the program there was very little in the literature to guide us in relation to best practices or outcomes measures,” explained Nidia I. Henderson, PEIA Clinical Services.
The need for results based in a “real world” environment was vital for the program’s future.
That’s how Abildso, along with Sam J. Zizzi, EdD and Bill Reger-Nash, EdD became involved.
In August 2008, the group conducted a survey to see if participants were following the program. They had access to nearly 2,000 records, allowing them to study participants at the 31 sites that offered the program benefit.
“The work of Dr. Abildso and Dr. Zizzi with the WVU College of Physical Activity and Sport Sciences has been invaluable in enabling us to make program adjustments based upon member interviews, focus groups, claims analysis and participant health benefits,” Henderson said. “As we move forward, this work will become even more critical given the challenges we face as a result of the epidemic of obesity and related chronic conditions.”
“This collaboration is truly unique and helps to bring positive attention to the College because we are making an impact on the health of West Virginians,” Zizzi said. “Just as importantly, it shows the leadership and openness of an insurance agency dedicated to provide a quality product through research and evaluation.”
Evaluations of weight management programs in real-world settings are lacking. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) model was used by the WVU group to evaluate the 12-week PEIA-sponsored weight management intervention by studying individual outcomes. The model provided useful framework to determine program strengths and weaknesses and to present them to the insurance agency and public health decision makers.
The study found that the weight management program is “effective and sustainable,” Abildso said, but needs to be expanded for more public health benefit.
“You want an effective program that reaches as many people as possible,” he said. “The PEIA weight management program, open to members meeting certain criteria, is very easily implemented. One-half of PEIA’s adult members are potentially eligible.”
Abildso wants to help expand the program further and notes that marketing is a key element for continued success. PEIA promotes the program through its participating sites, Worksite Wellness Program, publications and targeted mailings, but according to Henderson, “it never seems like enough.”
Currently, nearly 670 members participate at approximately 60 sites throughout West Virginia. Historically, the program has reached more than 6,000 total participants. Obese insured members are eligible for the program, as are overweight members who also report being treated for hypertension, diabetes, heart disease, metabolic syndrome or sleep apnea.
Participants enroll in the program by calling PEIA to be screened for height, weight and health information, and must have written approval from their primary care physician. Members may stay in the program for two years if they are successful and continue to attend the fitness center on a regular basis.
The weight management program uses a combination of behavior therapy such as food logs, individualized site-based exercise programming and individualized diet therapy. Nurses track monthly participant progress through a web-based database, using weight, BMI, blood pressure readings, body fat percentage, waist circumference and number of site visits.
Other states are aware of the program as PEIA representatives have presented results to the Council of State Governments, the National Governor’s Association and the State and Local Governments Benefits Association. Additionally, PEIA shared its model for weight management and related programs with Tennessee and North Carolina.
Henderson says additional West Virginia plans including Unicare, which services Medicaid recipients in the state, have reviewed PEIA’s model.
CONTACT: Kimberly Cameon, College of Physical Activity and Sport Sciences
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