A group of dedicated lifestyle medicine researchers within the UAB Department of Family and Community Medicine is leading the institution’s first randomized quality improvement (QI) project. The multi-phase study hopes to optimize enrollment into Sports & Exercise Medicine’s Fitness, Lifestyle, and Optimal Wellness (FLOW) program.
“There is an opportunity for us to lead the way as a learning health system by applying the same level of rigor to QI as other research projects by implementing rapid cycle, randomized testing to our processes,” said Drew Sayer, Ph.D., assistant professor and the study’s primary investigator. “The team is starting by evaluating our current process for FLOW referrals but looks forward to developing an optimization and evaluation cycle so that we can continually improve not only how we care for patients, but also how patients learn about our clinical options.”
The FLOW program—operated out of the Sports & Exercise Medicine Clinic at UAB Hospital-Highlands—includes a multidisciplinary team of diet, exercise, and psychology professionals who design tailored programs to support patients’ health journeys and goals. The program is open to any patient searching to embrace a healthier lifestyle, ages 12 and older but has a primary emphasis on weight and chronic disease management.
The QI project is a randomized encouragement trial and involves patients at the Family Medicine Clinic at UAB Hospital-Highlands who have a metabolic condition related to excess weight, such as prediabetes, type 2 diabetes, high blood pressure, or dyslipidemia.
With the encouragement trial design, all patients visiting the clinic who meet the FLOW program eligibility criteria are randomized to either receive direct encouragement to enroll in the FLOW clinic or to learn about the program through passive channels, such as brochures in the clinic lobby and waiting areas.
The overall goal of this project is to see if direct and targeted encouragement can increase rates of referral and enrollment in the FLOW program versus the standard passive advertising.
“While it would be fantastic for a brochure or digital signage to be the only encouragement a patient needs, the FLOW clinic is currently only serving a miniscule proportion of patients who would likely benefit,” explained Sayer.
If this process proves to be a more effective method to encourage patients, then this will be implemented as the new standard of care for referring patients to the FLOW program and potentially more clinic programs at UAB.
Sayer has also received a $500,000 grant from Eli Lilly to expand this QI project to test FLOW program referral techniques among patients with psoriatic arthritis and obesity. This grant will assist in extending encouragement efforts to rheumatology clinics at UAB and in the community.
As part of this study expansion, Sayer’s team is partnering with the NIAMS-funded Building and InnovatinG: Digital HeAlth Technology and Analytics (BIGDATA) Center and its’ Methods and Informatics Core, which brings innovative health information technology tools and methods to effectively advance the mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Ultimately, Sayer hopes that rigorous quality improvement projects like this can benefit patients, who are searching for obesity management options and lifestyle resources as more than 39% of adults in Alabama have been diagnosed with obesity and only 25% report getting regular exercise.
“While my team is currently focused on optimizing the referral process into the FLOW program, we’re tracking clinical and cost outcomes too,” said Sayer. “The first step is getting people into this program and establishing its current effectiveness, then we can begin to work on making FLOW an even better program for our patients.”