The Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC)

Description

Contacts

Chief Investigator: Professor Mark Fort Harris, email: m.f.harris@unsw.edu.au

CRE Manager / co-ordinator: Dr Catherine Spooner, email: c.spooner@unsw.edu.au

Website

http://compare-phc.unsw.edu.au/ 

Policy context

A quarter of the population is obese and this proportion has increased in all age groups by about 1 per cent a year over the past 30 years. Rates of obesity are particularly high and increasing in disadvantaged populations groups. This imposes a substantial burden on individuals, health services and the community in terms of higher incidence of diseases such as diabetes, higher hospitalisation rates and length of hospitalisation, disability and premature mortality. At total of 7.5 per cent of the burden of disease can be attributed to overweight or obesity. The Australian National Preventive Health Agency (ANPHA) has prioritised translational research on interventions to address obesity especially among children and adolescents, disadvantaged communities and Indigenous populations.

Preventing and managing obesity requires complementary intervention strategies through population health and primary health care (PHC). There is increasing evidence that PHC practitioners can assess the risks associated with obesity and effectively assist patients to lose weight and therefore reduce the risk of chronic disease. However, there is only sparse evidence on how this can be translated into routine practice, and what systems may be necessary to ensure widespread adoption. Assessment and brief advice are regularly provided to patients and are vital first steps, but are insufficient to initiate or achieve sustained weight loss. Referral to more intensive interventions such as those provided by allied health practitioners is required to achieve weight loss in obese patients but this occurs infrequently. There is also a lack of evidence for the effectiveness of strategies to maintain weight change in clinical practice. There are many barriers to referral and implementation of weight management by clinicians but little research has been conducted on how these barriers can be overcome, especially in disadvantaged populations

Synopsis

The Centre for Obesity Management and Prevention Research Excellence in Primary Health Care(COMPaRE–PHC) will address these problems with a two pronged approach.

Firstly, the Centre will conduct research across the lifecycle (families with young children, middle aged people at risk of chronic disease, older people with chronic illnesses) and with disadvantaged population groups (including Indigenous people) to evaluate new ways for primary care practitioners to deliver assessment, brief advice, goal setting, more intensive coaching and skill development, weight maintenance and relapse prevention. This includes innovative use of information technology (including web and social media), developing new roles for health care providers, and integrating interventions in PHC with local community services and resources. This research program will, by virtue of its embedding with health service structures and practices, have high generalisability and external validity in the Australian context (as interventions trialled overseas may not be directly translatable).

Secondly, the Centre will conduct research on how these innovative programs can be translated into routine practice. This aspect of the research will enable the implementation of the new National Health and Medical Research Council Obesity Prevention and Management Guidelines and the policies and initiatives of ANPHA. The translational research will address models for funding (of both health care services, providers and consumers), workforce development (including new roles and training for health professionals), the roles of Medicare Locals (including their roles in service development, coordination and facilitation), the roles of Indigenous health services, state and local government, and non government organisations, and links between PHC and population health programs and inter-sectoral initiatives.

Citations

  1. Gray J, Spooner C, Harris MF and Hoon E. (In Press). “I wasn't going to let that weight come back…” Understanding weight maintenance in the context of real life". ANZJPH.

  2. Taki S, Lymer S, Russell CG, Campbell K, Laws R, Ong KL, Elliott R, Denney-Wilson E. (In Press). Assessing user engagement of a mHeath intervention: development and implementation of the Growing healthy app Engagement Index. JMIR Mhealth Uhealth. http://mhealth.jmir.org doi:10.2196/mhealth.7236.

  3. Laws R, Hesketh KD, Ball K, Cooper C, Vrljic K, and Campbell KJ. (2016). Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program. BMC public health, 16. doi: 10.1186/s12889-016-3361-x

  4. Spooner C, Lavey L, Mukuka C, and Eames-Brown R. (2017). Multi-institution research centers: Planning and management challenges. Journal of Research Administration, XLVII(2), 32-48.

  5. Lakhan P, Askew D, Harris MF, Kirk C, and Hayman N. (2017). Understanding health talk in an urban Aboriginal and Torres Strait Islander primary healthcare service: a cross-sectional study. Aust J Prim Health. doi:10.1071/PY16162 
  6. Denney-Wilson E, Robinson A, Laws R, Harris MF, (2014). Development and feasibility of a child obesity prevention intervention in general practice: The Healthy 4 Life pilot study. Journal of Paediatrics and Child Health. doi:10.1111/jpc.12671
  7. Faruqi N, et al., (2015). Primary healthcare-level interventions improving health literacy for weight loss: A systematic review of the literature. BMC Obesity, 2(6) doi:10.1186/s40608-015-0035-7
  8. Faruqi N, Stocks N, Spooner C, Haddad Ne, Harris MF, (2015). Research Protocol: Management of obesity in patients with low health literacy in primary health care. BMC Obesity, 2(5) doi:10.1186/s40608-015-0036-6
  9. Harris MF, Spooner CJ, (2014). Weight loss options in general practice. The Medical Journal of Australia, 201(4):184-5
  10. Laws R, et al., (2014). The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review. BMC Public Health, 14(1):779
  11. Kim KK, Yeong L-L, Caterson ID, Harris MF, (2015). Analysis of factors influencing general practitioners' decision to refer obese patients in Australia: a qualitative study. BMC Family Practice, 16(45). doi:10.1186/s12875-015-0262-5. This article is now available online: http://www.biomedcentral.com/1471-2296/16/45
  12. Laws R, Campbell KJ, van der Pligt P, Ball K, Lynch J, Russell G, Taylor R, Denney-Wilson E. Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia. BMC Nurs. 2015;14:26. doi: 10.1186/s12912-015-0077-7
  13. Taki S, Campbell KJ, Russell CG, Elliot R, Laws R, Denney-Wilson E. Infant feeding websites and apps: A systematic assessment of quality and content. Interactive Journal of Medical Research 2015; 4(3): e18.
  14. Denney-Wilson E, et al. (2015) Preventing obesity in infants: the Growing healthy feasibility trial protocol. BMJ open 5(11). doi:10.1136/bmjopen-2015-009258
  15. Russell CG, Taki S, Laws RA, Azadi L, Campbell KJ, Elliot R, Lynch J, Ball K, Taylor R, and Denney-Wilson E. 2016. Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds: systematic review with narrative synthesis. BMC public health 16: 1-13. DOI: 10.1186/s12889-016-2801-y
  16. El-Haddad N, Spooner C, Faruqi N, Denney-Wilson E, and Harris M. (2016). Readability and content analysis of lifestyle education resources for weight management in Australian general practice. BMC Obesity, 3(1), 1-9. doi:10.1186/s40608-016-0097-1
  17. Russell CG, Taki S, Azadi L, Campbell KJ, Laws R, Elliott R, and Denney-Wilson E. (2016). A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment. BMC Pediatr, 16(1), 69. doi:10.1186/s12887-016-0601-2
  18. Harris MF, Laws RA: Are there bad foods or just bad diets? BMJ 2016, 353:i2442
  19. Russell CG, Taki S, Azadi L, Campbell KJ, Laws R, Elliott R, Denney-Wilson E: A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment. BMC Pediatr 2016, 16(1):69
  20. Russell CG, Taki S, Laws R, Azadi L, Campbell KJ, Elliott R, Lynch J, Ball K, Taylor R, Denney-Wilson E: Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds: systematic review with narrative synthesis. BMC Public Health 2016, 16(1):1-1
  21. Laws R, Hesketh K, Ball K, Cooper K, Vrjlic K, Campbell K. Translating an early childhood obesity prevention program for local community implementation: A Case Study of the Melbourne InFANT Program. BMC Public Health (in press)
  22. Laws R, Litterbach E, Denney-Wilson E, et al. A comparison of recruitment methods for a mobile health intervention targeting mothers: Lessons from the Growing healthy program. Journal of Medical Internet Research 2016; 18(9): e248.
  23. Gray J, Hoon EA, Afzali HHA, Spooner C, Harris MF, Karnon J. Is the Counterweight Program a feasible and acceptable option for structured weight management delivered by practice nurses in Australia? A mixed-methods study. Australian Journal of Primary Health 2017. http://www.publish.csiro.au/py/py16105

 

Publications indirectly related to COMPaRE-PHC research, and not funded by COMPaRE-PHC, but prepared by COMPaRE-PHC researchers

  1. Cameron AJ, Spence AC, Laws R, Hesketh KD, Lioret S, and Campbell KJ. (2015). A Review of the Relationship Between Socioeconomic Position and the Early-Life Predictors of Obesity. Current Obesity Reports, 4(3), 1-13. doi:10.1007/s13679-015-0168-5
  2. Harris MF. (2013). The metabolic syndrome. Australian Family Physician, 42(8), 524-527
  3. Harris MF, and Laws RA. (2016). Are there bad foods or just bad diets? BMJ, 353, i2442. doi:10.1136/bmj.i2442

 

Invited conference and other presentations

  1. Denney-Wilson E (2015) Rethinking infant feeding advice to parents.  Tresillian annual conference, 27th November, Sydney
  2. Harris, M (2105) People centred research for people centre health system. 4th Annual NHMRC Symposium on Research Translation. Sydney, 27-28 October 2015 (invited plenary)
  3. Harris, M (2015) National Strategic Framework for Chronic Conditions – Roundtable Workshop, Canberra
  4. Laws R, Campbell K, Azadi L, et al. Growing healthy program (Invited presentation). Australian Breastfeeding Association Victorian Branch Conference. Melbourne, 2015.
  5. Spooner C. Obesity Management (Invited guest lecture). Sydney: University of New South Wales, 2015.
  6. Harris, M. (2016). Health Literacy & clinical practice. Presentation at a COMPARE-PHC event at Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service) on 2 June: Health Literacy: Why does it matter? Brisbane
  7. Lakhan, P. (2016). Understanding health talk. Presentation at a COMPARE-PHC event at Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service) on 2 June: Health Literacy: Why does it matter? Brisbane
  8. El-Haddad N. (2016). Readability and content analysis of lifestyle education resources for weight management in Australian general practice  (poster). Paper presented at the Dietitians Association of Australia 33rd National Conference, Melbourne
  9. Faruqi, N., Spooner, C., Hermiz, O., Stocks, N., & Harris, M. (2016). Relationship of health literacy with diet and physical activity of obese patients attending general practice in socioeconomically disadvantaged areas (poster) Paper presented at the Primary Health Care Research Conference, Canberra
  10. Spooner, C., Faruqi, N., Hermiz, O., Stocks, N., & Harris, M. (2016). Self esteem and public distress experienced by of obese patients attending general practice in socioeconomically disadvantaged areas. Paper presented at the Primary Health Care Research Conference, Canberra. Oral presentation retrieved from http://compare-phc.unsw.edu.au/sites/default/files/upload/Session_Catherine_Spooner%20%288Jun2016%29.pdf
  11. Harris, M. (2016). Health Literacy in Primary Health Care: what we have learnt (live presentation and webinar). COMPARE-PHC Symposium on health literacy. Sydney
  12. Karnon, J., Gray, J., & Harris, M. (2016). Managing obesity in general practice (webinar). COMPARE-PHC webinar presented via HSRAANZ on 26 May
  13. Taki, S., Laws, R., Campbell, K., Russell, G., Lynch, J., Ball, K.,  Denney-Wilson, E. (2014). What’s APPening in Infant Feeding? (Poster). Paper presented at the Innovation Alley TEDx Bond University, Gold Coast, QLD. Poster retrieved from http://compare-phc.unsw.edu.au/node/467
  14. Harris, M., Faruq, N., Spooner, C., Hermiz, O., & Stocks, N. (2016). Obesity and health literacy in general practice. Paper presented at the NAPCRG Annual Meeting, Colorado Springs, Colorado
  15. Taki, S., Lymer, S., Ong, K. L., Campbell, K. J., Russell, C. G., Laws, R., & Denney-Wilson, E. (2016). The development and application of an engagement index on the participants’ use of an infant feeding app: the Growing healthy program (poster). Paper presented at the Behaviour Change Conference: Digital Health and Wellbeing, London. Poster retrieved from http://compare-phc.unsw.edu.au/node/462
  16. Taki, S., Russell, C. G., Campbell, K. J., Laws, R., & Denney-Wilson, E. (2016). Exploration of mothers’ engagement with the Growing Healthy program: a week-by-week app to promote healthy infant feeding practices (poster). Paper presented at the Behaviour Change Conference: Digital Health and Wellbeing, London. Poster retrieved from http://compare-phc.unsw.edu.au/node/463
  17. Laws, R., & Taki, S. (2016). Growing healthy. Paper presented as part of a workshop on m-health at the Dietitians Association of Australia 33rd National Conference, Melbourne. http://compare-phc.unsw.edu.au/node/464
  18. Spooner, C. (2016). Obesity and lifestyle (invited workshop). Workshop for students and staff at the National Institute of Dramatic Art. Sydney: UNSW

 

Articles in the media

  1. Denney-Wilson E. New app to help parents feed baby for life. Radio 2SER (1073), 2015.
  2. Denney-Wilson E. It’s  a secret formula for fat babies. Sunday Telegraph, 2015.
  3. Harris M. Exercise and the great weight loss myth. In: Stiles J, ed. The New Daily, 2015.
  4. Harris M. Why it's so tough to help patients lose weight. In: Scully RP, ed. Medical Observer, 2015.
  5. Harris M. Poor health literacy the reason for Australian obesity epidemic. The Advertiser, 2015.
  6. Harris M. Poor health literacy, not lack of motivation, the culprit for Australian obesity epidemic. Daily Telegraph, 2015.
  7. Harris M. UNSW study finds GPs failing to help patients beat the bulge (Media Release). In: Wheelahan D, ed. UNSW Newsroom, 2015.
  8. Harris M. Are you health literate? . In: Swan N, ed. Health Report, Radio National, 2015.
  9. Harris M. GPs criticised for dropping the ball on obesity. In: Taylor D, ed. The World Today, ABC News, 2015.
  10. Harris M. GPs failing to help obese patients lose weight after mistaking low health literacy for laziness, new research finds. In: Taylor D, ed. The World Today, ABC News, 2015.
  11. Harris M, Denney-Wilson E. More work needed to help GPs educate patients about healthy Radio 2SER (1073), 2015.
  12. Taki S. Dr Google not giving right answers. Radio 2SER (1073), 2015.
  13. Harris M: Battling Australia’s bulge. In: This Week in PHC. Edited by PHCRIS. Adelaide: Primary Health Care Research & Information Service; 2016
  14. Harris M: Why Australia needs to improve in health literacy. In: Croakey. Edited by Doggett J; 2016

 

Professional resources

  • At the request of our Advisory Committee representative from APNA, we developed an online training course for primary health care nurses on weight management. This will be available for free from the APNA website (expected availability September 2016), providing CPD points. We have also negotiated for it to be able to be accessed from other sites, such as the COMPaRE-PHC website
  • We have worked with Sydney HealthPathways to develop an obesity management pathway. This will form the basis of referral pathways across the country

 

 

Updated:  20 September 2017/Responsible Officer:  Director, APHCRI/Page Contact:  Web Admin, APHCRI