期刊论文详细信息
BMC Health Services Research
Weight management in Canada: an environmental scan of health services for adults with obesity
Marie-France Langlois3  Jean-Pierre Chanoine1  Geoff DC Ball4  Christine Brown2  Marie-Michèle Rosa Fortin2 
[1] Endocrinology and Diabetes Unit, British Columbia Children’s Hospital and University of British Columbia, British Columbia, Canada;Centre de recherche clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada;Department of Medicine, Division of Endocrinology, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada;Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada
关键词: Primary care;    Multidisciplinary team;    Bariatric surgery;    Weight management;    Obesity;   
Others  :  1134110
DOI  :  10.1186/1472-6963-14-69
 received in 2013-11-27, accepted in 2014-02-05,  发布年份 2014
PDF
【 摘 要 】

Background

Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care.

Methods

We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ).

Results

A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling.

Conclusions

With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults.

【 授权许可】

   
2014 Rosa Fortin et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150305074338650.pdf 341KB PDF download
Figure 3. 31KB Image download
Figure 2. 40KB Image download
Figure 1. 26KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Canada S: Canadian Community Health Survey, Cycle 2.2, Nutrition (2004). In. Health Canada: Ottawa; 2004.
  • [2]NHLBI Obesity Education Initiative Expert Panel on the Identification Evaluation and Treatment of Obesity in Adults (US): Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults--the evidence report. National institutes of health. Obes Res 1998, 6(Suppl 2):51S-209S.
  • [3]WHO: Obesity: preventing and managing the global epidemic. 894th edition. Geneva, Switzerland: WHO technical report series; 2000.
  • [4]Kortt M, Baldry J: The association between musculoskeletal disorders and obesity. Aust Health Rev 2002, 25(6):207-214.
  • [5]Anis AH, Zhang W, Bansback N, Guh DP, Amarsi Z, Birmingham CL: Obesity and overweight in Canada: an updated cost-of-illness study. Obes Rev 2009, 11(1):31-40.
  • [6]Health Canada: The Government of Canada reaffirms its commitment to combat Canada's rising obesity levels. Ottawa: Health Canada; 2005.
  • [7]Alberta Health Services: Becoming the Best: Alberta’s 5-Year Health Action Plan 2010-2015. Edmonton: Governement of Alberta; 2010.
  • [8]Bariatric surgery: an evidence-based analysis Ont Health Technol Assess Ser 2005, 5(1):1-148.
  • [9]Ministère de la Santé et des Services Sociaux du Québec: L'organisation de la chirurgie bariatrique au Québec: Plan d'action. In La Direction des communications du ministère de la Santé et des Services sociaux du Québec edn. Québec: Gouvernement du Québec; 2009.
  • [10]Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E: 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. Cmaj 2007, 176(8):S1-13.
  • [11]Kirk SF, Tytus R, Tsuyuki RT, Sharma AM: Weight management experiences of overweight and obese Canadian adults: findings from a national survey. Chronic Dis Inj Canada 32(2):8.
  • [12]Mongeau L, Vennes M, Sauriol V: Losing weight for better, not worse : guidebook on the principles of healthy weight management and on a critical analysis of weight-loss products and services. Montréal: Association pour la santé publique du Québec; 2005:64.
  • [13]CIHR: Developing a research agenda to support bariatric care in Canada workshop report. Montréal: CIHR Institute of Nutrition, Metabolism and Diabetes and The Canadian Obesity Network; 2010:35.
  • [14]Ball GD, Ambler KA, Chanoine JP: Pediatric weight management programs in Canada: where, what and How? Int J Pediatr Obes 2011, Jun, 6(2–2):e58-61.
  • [15]Siegel S, Marshall L, Cummings L: Obesity treatment programs in public hospitals and health systems. Washington: National Association of Public Hospitals and Health Systems; 2008.
  • [16]Janssen I, Shields M, Craig CL, Tremblay MS: Prevalence and secular changes in abdominal obesity in Canadian adolescents and adults, 1981 to 2007-2009. Obes Rev 2010, 12(6):397-405.
  • [17]Xu Q, Anderson D, Lurie-Beck J: The relationship between abdominal obesity and depression in the general population: a systematic review and meta-analysis. Obes Res Clin Pract 2011, 5:e267-e278.
  • [18]Lykouras L: Psychological profile of obese patients. Dig Dis 2008, 26(1):36-39.
  • [19]Dahl JK, Eriksen L, Vedul-Kjelsås E, Strømmen M, Kulseng B, Mårvik R, Holen A: Depression, anxiety, and neuroticism in obese patients waiting for bariatric surgery: Differences between patients with and without eating disorders and subthreshold binge eating disorders. Obes Res Clin Pract 2012, 6:e139-e147.
  • [20]LeMont D, Moorehead MK, Parish MS, Reto CS, Ritz SJ: Suggestions for the pre-surgical psychological assessement of bariatric surgery candidates. Gainesville, Florida: American Society for Bariatric Surgery; 2004.
  • [21]Wadden TA, Sarwer DB, Williams NN: Behavioral assessment and characteristics of patients seeking bariatric surgery. Obesity (Silver Spring) 2006, 14(Suppl 2):51S-52S.
  • [22]Collazo-Clavell ML, Clark MM, McAlpine DE, Jensen MD: Assessment and preparation of patients for bariatric surgery. Mayo ClinProc 2006, 81(10 Suppl):S11-17.
  • [23]National Confidential Enquiry into Patient Outcome and Death (NCEPOD): Too Lean a Service? A review of the care of patients who underwent bariatric surgery. London: NCEPOD; 2012.
  • [24]Douketis JD, Feightner JW, Attia J, Feldman WF: Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity. Canadian Task Force on Preventive Health Care. Cmaj 1999, 160(4):513-525.
  • [25]NHS Centre for Reviews and Dissemination: The prevention and treatment of obesity. Effective Health Care Bulletins 1997, 3(2):1-12.
  • [26]Kirk SF, Penney TL, McHugh TL, Sharma AM: Effective weight management practice: a review of the lifestyle intervention evidence. Int J Obes (Lond) 2012, 36(2):178-185.
  • [27]Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR: Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999, 282(15):1458-1465.
  • [28]Puhl R, Brownell KD: Bias, discrimination, and obesity. Obes Res 2001, 9(12):788-805.
  • [29]Puhl RM, Heuer CA: The stigma of obesity: a review and update. Obesity (Silver Spring) 2009, 17(5):941-964.
  • [30]Peacock JC, Zizzi SJ: An assessment of patient behavioral requirements pre- and post-surgery at accredited weight loss surgical centers. Obes Surg 2011, 21(12):1950-1957.
  • [31]Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, Ko CY, Gibbons MM: Exercise following bariatric surgery: systematic review. Obes Surg 2010, 20(5):657-665.
  • [32]Egberts K, Brown WA, Brennan L, O'Brien PE: Does exercise improve weight loss after bariatric surgery? A systematic review. Obes Surg 2012, 22(2):335-341.
  • [33]Jacobi D, Ciangura C, Couet C, Oppert JM: Physical activity and weight loss following bariatric surgery. Obes Rev 2011, 12(5):366-377.
  • [34]Schoeller DA, Shay K, Kushner RF: How much physical activity is needed to minimize weight gain in previously obese women? Am J ClinNutr 1997, 66(3):551-556.
  • [35]Donnelly JE, Smith B, Jacobsen DJ, Kirk E, Dubose K, Hyder M, Bailey B, Washburn R: The role of exercise for weight loss and maintenance. Best Pract Res ClinGastroenterol 2004, 18(6):1009-1029.
  • [36]Elfhag K, Rossner S: Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 2005, 6(1):67-85.
  文献评价指标  
  下载次数:41次 浏览次数:35次