In the U.S, 30% of adults have obesity. Without significant intervention, it is estimated that 51% of the American adult population will have obesity by 2030.
Obesity plays a causal role in heart disease, stroke, high blood pressure, diabetes, gallbladder disease, sleep apnea and certain cancers. Across the MaineHealth system, 71% (n = 65,605) of MaineHealth primary care patients have overweight and/or obesity, according to recent data from the electronic medical record, EPIC. Sixteen percent (n = 10,255) of those patients with overweight and/or obesity have also been diagnosed with diabetes.
Small Steps helps primary care providers care for adults by providing training around evidence-based next steps and how to support patients in managing and improving their health. This program advocates:
Move More – it’s a great way to improve your health
Eat Real – foods that come from nature give you energy
Drink Water – it’s the best choice
Rest Up – good sleep restores your body and mind
Small Steps asks primary care practices to:
Deliver key messages using Small Steps posters in all exam rooms and waiting room
Accurately measure weight and height, calculate BMI
Engage in shared decision making using the Healthy Habits Questionnaire
Utilize motivational interviewing to help patients set goals
Develop and document a follow up plan for patients whose BMI is above the normal range
In 2016-2017, Small Steps was piloted with six Maine Medical Partners primary care practices and evaluation results showed that patients and providers found the messages, workflow, tools and resources useful. After the pilot program was complete, Small Steps expanded to 7 additional primary care practices, reaching over 66,000 adults.
Small Steps continues to expand across the MaineHealth system. This program will include an adult obesity clinical care pathway to support the work as well as work to achieve the following measures among MaineHealth member-owned family and internal medicine practices:
>80% of practices will complete training on adult obesity standard of care by September 30, 2018.
>50% of practices will implement components of standard of care by September 30, 2018.
Tools for Health Care Practices
Let’s Go! offers a variety of resources to help practices implement the Small Steps Program.