Chief investigators

• Professor Mark Harris, Professor of General Practice and Director of Centre for Primary Health Care and Equity, University of New South Wales
• Professor Adrian Bauman, School of Public Health, Sydney University
• Dr Rachel Laws, University of Sydney
• Professor Ian Caterson, Director, Boden Institute, University of Sydney
• Professor Karen Campbell, Centre for Physical Activity and Nutrition Research,
• Deakin University                                                                                                                                  
• Professor David Crawford, Director, Centre for Physical Activity and Nutrition Research, and Head, School of Exercise and Nutrition Sciences, Deakin University    
• Professor Nigel Stocks, Professor and Head of Discipline of General Practice, University of Adelaide
• Professor Noel Hayman, Clinical Director, Inala Indigenous Health Service
• DrElizabeth Denney-Wilson, University of Technology Sydney
• Professor Siaw Teng Liaw, Professor of General Practice, Flinders University of South Australia
• Professor John Lynch, Professor of Public Health,University of Adelaide

Policy context

A quarter of the population is obese and this proportion has increased in all age groups by about 1% 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% 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.