# Increasing Access to USPSTF-Recommended Obesity Care for Youth and Adults Who Are Recipients of Medicaid: Evaluation of a Comprehensive Multidisciplinary Obesity Care Training Program in FQHCs

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $648,214

## Abstract

Obesity in adults and children is associated with severe disease and poor quality of life, and disproportionately
impacts rural communities and historically marginalized groups. Increased access to quality obesity care is an
important strategy for reducing obesity-related inequities. The US Preventive Services Task Force (USPSTF)
recommends primary care providers (PCPs) screen children and adults for obesity and offer or refer to
comprehensive, intensive behavioral interventions (IBTs); however, these recommendations are rarely
implemented. Lack of training for both PCPs and behavioral health providers (BHPs) is a major barrier to
implementation of USPSTF-care. Other key barriers include workforce challenges, care fragmentation, clinician
weight bias, limited clinic-community linkages, and patient-level socioeconomic barriers. Harnessing an
upcoming Medicaid policy change, our team developed a scalable implementation strategy, Comprehensive
Multidisciplinary Obesity Care (CMOC). We propose to train a collaborative team (i.e., PCPs, BHPs, Registered
Dietitian Nutritionists, and community health workers) to implement USPSTF-care in Federally Qualified Health
Centers (FQHCs). CMOC is an innovative approach that leverages policy supports, clinic-community linkages,
and digital technology, and employs a comprehensive, multi-level training program addressing structural and
systemic contributors (e.g., clinician weight bias) to health inequities to improve weight-related outcomes and
sustain impact. Using an effectiveness-implementation design with a cluster randomized controlled trial (RCT)
phase and a one-way crossover phase, 20 FQHCs in urban and rural areas of Missouri including ~100 PCPs
and ~6,000 benefit-eligible patients (i.e., Medicaid recipients with obesity) will be assigned to CMOC or an
implementation as usual control (IAUC) condition. CMOC includes provider training in obesity care competencies
(e.g., weight bias reduction, structural competency), discipline-specific USPSTF-care, and learning
collaboratives over 12 months, followed by a 12-month sustainability period. The one-way crossover phase
implements CMOC in the control arm (following their participation in IAUC) over 12 months. Both phases include
evaluations at 12- and 24-months post-training. To improve health outcomes among historically marginalized
groups, our proposed study evaluates short- and long-term clinical and implementation outcomes of CMOC
compared to IAUC using RE-AIM. Four aims will guide this work. Aim 1 compares patient-level effectiveness
(i.e., patient relative weight change (1a) and the proportion of patients who achieve clinically significant weight
loss (1b)). Aim 2 compares reach (patient treatment utilization). Aim 3 compares PCP referrals to care at 12
(adoption; 3a) and 24 months (maintenance; 3b), and short- and long-term changes in provider obesity care
competencies (3c). Aim 4 compares implementation and service costs. In line with NIDDK Strategic Prior...

## Key facts

- **NIH application ID:** 10918327
- **Project number:** 5R01DK134961-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Sarah Elizabeth Hampl
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $648,214
- **Award type:** 5
- **Project period:** 2023-09-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10918327

## Citation

> US National Institutes of Health, RePORTER application 10918327, Increasing Access to USPSTF-Recommended Obesity Care for Youth and Adults Who Are Recipients of Medicaid: Evaluation of a Comprehensive Multidisciplinary Obesity Care Training Program in FQHCs (5R01DK134961-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10918327. Licensed CC0.

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