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Best practices in the Veterans Health Administration's MOVE! Weight management program.

Publication ,  Journal Article
Kahwati, LC; Lewis, MA; Kane, H; Williams, PA; Nerz, P; Jones, KR; Lance, TX; Vaisey, S; Kinsinger, LS
Published in: American journal of preventive medicine
November 2011

Obesity is a substantial problem in the Veterans Health Administration (VHA). VHA developed and disseminated the MOVE! Weight Management Program for Veterans to its medical facilities but implementation of the program has been variable.The objective was to explore variation in MOVE! program implementation to identify facility structure, policies, and processes associated with larger patient weight-loss outcomes.Qualitative comparative analysis (QCA) was used to identify facility conditions or combinations of conditions associated with larger 6-month patient weight-loss outcomes. QCA is a method that allows for systematic cross-case comparison to better understand causal complexity. Eleven sites with larger outcomes and 11 sites with smaller outcomes were identified and data were collected with site interviews, facility-completed program summary forms, and medical record abstraction in 2009 and 2010. Conditions were selected based on theory and experience implementing MOVE! and were calibrated using QCA methods. Configuration patterns were examined to identify necessary conditions (i.e., always present when outcome present, but alone do not guarantee outcome) and sufficient conditions (i.e., presence guarantees outcome) at sites with larger and smaller outcomes. A thematic analysis of site interview data supplemented QCA findings.No two sites shared the same condition pattern. Necessary conditions included the use of a standard curriculum and group care-delivery format, and they were present at all sites with larger outcomes but at only six sites with smaller outcomes. At the 17 sites with both necessary conditions, four combinations of conditions were identified that accounted for all sites with larger outcomes. These included high program complexity combined with high staff involvement; group care-delivery format combined with low accountability to facility leadership; an active physician champion combined with low accountability to facility leadership; and the use of quality-improvement strategies combined with not using a waiting list.The use of a standard curriculum delivered with a group care-delivery format is an essential feature of successful VHA facility MOVE! Weight Management Programs, but alone does not guarantee success. Program development and policy will be used to ensure dissemination of the best practices identified in this evaluation.

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Published In

American journal of preventive medicine

DOI

EISSN

1873-2607

ISSN

0749-3797

Publication Date

November 2011

Volume

41

Issue

5

Start / End Page

457 / 464

Related Subject Headings

  • Weight Loss
  • Waiting Lists
  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Quality Assurance, Health Care
  • Public Health
  • Program Evaluation
  • Program Development
  • Obesity
 

Citation

APA
Chicago
ICMJE
MLA
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Kahwati, L. C., Lewis, M. A., Kane, H., Williams, P. A., Nerz, P., Jones, K. R., … Kinsinger, L. S. (2011). Best practices in the Veterans Health Administration's MOVE! Weight management program. American Journal of Preventive Medicine, 41(5), 457–464. https://doi.org/10.1016/j.amepre.2011.06.047
Kahwati, Leila C., Megan A. Lewis, Heather Kane, Pamela A. Williams, Patrick Nerz, Kenneth R. Jones, Trang X. Lance, Stephen Vaisey, and Linda S. Kinsinger. “Best practices in the Veterans Health Administration's MOVE! Weight management program.American Journal of Preventive Medicine 41, no. 5 (November 2011): 457–64. https://doi.org/10.1016/j.amepre.2011.06.047.
Kahwati LC, Lewis MA, Kane H, Williams PA, Nerz P, Jones KR, et al. Best practices in the Veterans Health Administration's MOVE! Weight management program. American journal of preventive medicine. 2011 Nov;41(5):457–64.
Kahwati, Leila C., et al. “Best practices in the Veterans Health Administration's MOVE! Weight management program.American Journal of Preventive Medicine, vol. 41, no. 5, Nov. 2011, pp. 457–64. Epmc, doi:10.1016/j.amepre.2011.06.047.
Kahwati LC, Lewis MA, Kane H, Williams PA, Nerz P, Jones KR, Lance TX, Vaisey S, Kinsinger LS. Best practices in the Veterans Health Administration's MOVE! Weight management program. American journal of preventive medicine. 2011 Nov;41(5):457–464.
Journal cover image

Published In

American journal of preventive medicine

DOI

EISSN

1873-2607

ISSN

0749-3797

Publication Date

November 2011

Volume

41

Issue

5

Start / End Page

457 / 464

Related Subject Headings

  • Weight Loss
  • Waiting Lists
  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Quality Assurance, Health Care
  • Public Health
  • Program Evaluation
  • Program Development
  • Obesity