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April 28, 2008
By Anne McMillin
Two researchers from the University of Nevada, Reno and the University of Nevada School of Medicine have received a grant to study obesity in Nevada’s adult population.
Judith Ashley, an associate professor of nutrition for the College of Agriculture, Biotechnology and Natural Resources, and Doina Kulick, M.D., with the School of Medicine’s department of internal medicine, will combine forces for a one-year study entitled “A model for a primary care weight management program for underserved populations.”
The State of Nevada, Department of Health and Human Services Health Division, Trust Fund for Public Health granted the award in the amount of $98,890 effective July 1.
Obesity currently affects two thirds of Nevada’s adults and constitutes the state’s most prevalent modifiable health risk factor.
“Obese people have at least twice the risk of normal weight persons for diabetes, hypertension, dyslipidemia, heart disease, stroke, sleep apnea, debilitating osteoarthritis, and cancer,” said Kulick, an internist with University Health System, the clinical practice of the School of Medicine, and assistant professor at the School.
The barriers to better address obesity by the current healthcare system are numerous, but lack of time, reimbursement, and support play an important role. Physician support from dietitians is a challenge, especially in Nevada which ranks the lowest state in the nation, with only 8.99 dietitians per 100,000 population (national average is 16.26 dietitians per 100,000 population).
“The university in collaboration with Nevada Health Centers, Inc. proposes a novel, cost-effective, primary healthcare-based small group intervention for the prevention and treatment of overweight and obesity in the underserved population,” said Ashley. “This intervention will use medical assistants, who are already part of the primary care team, and are more cost-effective than a dietitian or a behavior therapist. They will receive focused, on-job training as ‘weight management coaches,’ which will enable them to efficiently deliver a well-structured, cognitive-behavioral and nutrition education program developed by experts.”
This primary care physician supervised intervention is intended to alleviate the lack of infrastructure and medical services needed to assist overweight and obese patients. The patient-primary care physician relationship is usually of long-term, and thus offers the best path to address a chronic medical problem such as obesity.