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Evidence-based Communication Strategies to Engage and Motivate Obese Patients

Improving Obesity Outcomes in Primary Care
0.5 AAFP Prescribed Credit(s) 0.5 CA-BRN Credit(s) 0.5 AMA PRA Category 1 Credit(s)
Launch Date:
December 02, 2014
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Family Physicians and other Primary Care Physicians and all practice team members and other specialists who address obesity.

Relevant Terms:


Paula Gardiner, MD

Paula Gardiner, MD
Assistant Professor of Family Medicine
Boston University School of Medicine
Assistant Director of Integrative Medicine
Boston Medical Center
Boston, MA

Dr. Paula Gardiner is the Assistant Director for the Program for Integrative Medicine and Health Care Disparities at Boston Medical Center. She is an Assistant Professor in the Department of Family Medicine at Boston University School of Medicine. She received her MD from the Tuft University Medical School and completed her residency in Family Medicine at Tuft University Medical School. She completed a three year Clinical Research Fellowship in Complementary and Alternative Medicine Research and Faculty Development at Harvard Medical School. She received her MPH from Harvard School of Public Health.

Additionally, she has been awarded a five year NIH K award grant focusing on dietary supplement use in the inner city underserved medical settings. She is the primary investigator on a PCORI grant to study an innovative care model called the integrative medicine group visit (IMGV) for racial diverse patients with chronic pain and depression. This model combines Mindfulness Based Stress Reduction with a medical group visit.

Dr. Gardiner is also interested in safety and quality issues of dietary supplements for women and children. Dr. Gardiner lectures nationally and internationally. She has published over forty peer reviewed papers on dietary supplements, pregnancy, preconception care, stress, and complementary medicine in underserved patients.

Suzanne E. Mitchell, MD

Suzanne E. Mitchell, MD
Assistant Professor, Family Medicine
Boston University School of Medicine
Boston Medical Center
Boston, MA

Dr. Mitchell is Assistant Professor of Family Medicine at Boston University School of Medicine/ Boston Medical Center and board certified in family and palliative medicine. She received her medical degree from Wake Forest University School of Medicine and Masters of Science in Clinical Research from UCLA. Dr. Mitchell completed family medicine residency training at the White Memorial Medical Center Family Medicine Residency program in Los Angeles, CA where she continued her work and research in cross cultural communication and cultural competency until 2006 when she relocated to Boston, MA. She completed the Boston University academic fellowship and received and AHRQ mentored clinical researcher award in 2010 to study the impact of patient-doctor communication on health disparities, health service utilization and shared decision making behavior.
Dr. Mitchell is a member of the research team on transitions of care and the Project Re-Engineered Discharge (RED) at Boston University. She is a co-principal investigator on the current Project RED-Depression trial studying the effectiveness of mental health support to reduce readmissions. She also has a special interest in the use of novel health technology to enhance patient safety and informed patient choice. Dr. Mitchell is an active member of the teaching faculty at the Boston University School of Medicine and continues to practice primary and palliative care in medically underserved communities of the Boston area.
1. Use evidence-based guidelines and tools such as Motivational Interviewing and Stages of Change, to improve communication, patient engagement/motivation and management

Evidence-based Communication Strategies to Engage and Motivate Obese Patients
This activity is sponsored by the California Academy of Family Physicians 

Target Audience
This activity is intended for family medicine physicians, endocrinologists and other primary care providers and team members who manage patients with obesity.

Accreditation Statement    
The California Academy of Family Physicians is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 
The California Academy of Family Physicians designates this educational activity for a maximum of .50 AMA PRA Category 1 Credit(s).  Physicians should only claim credit commensurate with the extent of their participation in the activity.
CAFP is certified as a continuing education provider (number 1809) by the California Board of Registered Nursing. This certificate must be retained by the licensee for a period of four years after the conclusion of the course.

Evidence-based Communication Strategies to Engage and Motivate Obese Patients has been reviewed and is acceptable for up to .50 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins December 2, 2014. Term of approval is for one year from this date.  

Conflict of Interest Statements
The CAFP Committee on Continuing Professional Development is responsible for management and resolution of conflict for any individual who may have influence on content, who have served as faculty, or who may produce CME/CPD content for the CAFP. Management/Resolution may include learner notification, peer review of content before presentation, requirement of EB-CME, changing topics, or even dismissing a potential planning or faculty member. 
It is the policy of the CAFP to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. All individuals with potential to influence the content of this program have submitted Conflict of Interest declarations that have been reviewed according to policy. Learner notification of declarations is below. All individuals with potential conflicts have been contacted by CAFP staff or CCPD members, and issues of conflict have been discussed, managed, and resolved.
Faculty Disclosures
  • Paula Gardiner, MD, declares that in the past 12 months neither she nor any member of her family have had a financial arrangement or affiliation with any corporate organization offering financial support of grant moneys for this continuing education program.
  • Suzanne E. Mitchell, MD, declares that in the past 12 months she has received speaker honoraria for the topic of relationship-centered care from Merck however neither she nor any member of her family have had a financial arrangement or affiliation with any corporate organization offering financial support of grant moneys for this continuing education program.
  • Shelly Rodrigues, CAE, FACEHP, CAFP staff, nor any member of her family have any conflicts of interest with commercial interests related directly or indirectly to this educational activity.
  • Cynthia Kear, CCMEP, CAFP staff, nor any member of her family have any conflicts of interest with commercial interests related directly or indirectly to this educational activity.
  • Jerri Davis, CCMEP, CAFP staff, nor any member of her family have any conflicts of interest with commercial interests related directly or indirectly to this educational activity.
  • Chris Larrison, Healthcare Performance Consulting, nor any member of his family have any conflicts of interest with commercial interests related directly or indirectly to this educational activity.
Instructions for Participation and Credit
Learners must register to participate in and receive credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™ and AAFP Prescribed Credit, you must receive a minimum score of 65% on the post-test. Upon successful completion of the post-test, the learner will receive a certificate of participation that can be used to claim CME credit.

Steps to Earn CME/CE credit
Read the target audience, learning objectives, and author disclosures. Study the educational content online or printed out. Online, choose the best answer to each post-test question. To receive a certificate, you must receive a passing score as designated at the top of the test and complete the Activity Evaluation.
Your certificate will be emailed to the address you provided when registering. You may print the certificate, but you cannot alter it. 

For questions regarding the content of this activity or for technical assistance, contact cafp@familydocs.org.
The CAFP has made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education program.  Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the learner is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.
Approval of credit for this continuing education program does not imply endorsement by CAFP of any product or manufacturer identified.
Any medications or treatment methods suggested in this CME activity should not be used by the practitioner without evaluation of their patient's condition(s) and possible contraindication(s) or danger(s) of use of any specific medication.

Unlabeled Use Disclosure
This activity will not include discussions of products or devices that are not currently approved for use by the Food and Drug Administration (FDA), or are currently investigational.
Support grant/s       
This activity is supported by an unrestricted grant from Takeda Pharmaceuticals.

Needs Statement 
The epidemic of obesity is now recognized as one of the most important public health problems facing the world today. Worldwide obesity has nearly doubled since 1980. Tragically, adult obesity is more common globally than under-nutrition. More than two-thirds of Americans today are overweight, defined as a Body Mass Index (BMI) of greater than or equal to 25, and around one third of the population is obese, with a BMI of greater than or equal to 30. As overweight patients increase in both number and severity, the burden on the economy, the health system, patient quality of life, and patient health outcomes continues to grow as well.
Primary care providers play an important role in obesity management, since they often serve as the patients' first, only and/or primary point-of-contact with the health care system. However, most studies show that screening and counseling for obesity is not occurring regularly during primary care office visits. The U.S. Preventive Services Task Force (USPSTF) has recommended that clinicians screen all adults for obesity and offer intensive multicomponent behavioral interventions to affected individuals, either by providing such treatment themselves or referring patients to appropriate interventions.1
While studies have shown that basic counseling about healthy behaviors takes less than five minutes, physicians often do not incorporate it into the visit.2 The odds of receiving weight loss counseling are best in severely obese patients, patients with documented diagnoses of obesity, and those with weight-related co-morbidities.3 Patients with co-morbid conditions linked to obesity tend to receive counseling more often than their equal weight counterparts, indicating that primary care providers do not manage obesity as an independent medical condition. Even for patients with documented obesity, physicians only discuss weight 65 percent of the time, recommend exercise 62 percent of the time, and refer patients for nutritional counseling 25 percent of the time.3 This low level of counseling and referral indicate that there are barriers preventing providers and patients from successfully initiating discussions about weight.
Moyer, V.A. on behalf of the U.S. Preventive Services Task Force. 2012. Screening for and management of obesity in adults. U.S. Preventive Services Task Force recommendation statement. Ann. Intern. Med. 157:373–378.
Albright, C.L., Cohen, S., Gibbons, L., et al. Incorporating physical activity advice into primary care: physician-delivered advice within the activity counseling trial. Am J Prev Med. 2000;18:225-234.
Waring, M.E., Robert, M.B., Parker, D.R., Eaton, C.B. Documentation and management of overweight and obesity in primary care. JABFM. 2009;22(5):544-552. http://www.jabfm.org/cgi/content/abstract/22/5/544.

There is no charge for this activity.
Cultural/Linguistic Competency
CAFP policy and California state law requires that each learning activity have elements of cultural and linguistic proficiency included in the content. This activity includes these elements.

Course Viewing Requirements
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Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 5.0+ for Mac OSX 10.5 and above

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Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above


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© 2014 California Academy of Family Physicians. All rights reserved. No part of this activity may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.