Dr. Wee's long-term goal is to become an independent clinical and health services researcher in obesity, with a focus on improving the management of patients with obesity in primary care. Many common diseases seen in primary care practice are consequences of obesity. Yet obesity continues to be largely ignored by primary care physicians. Reasons for this lack of physician effort include time constraints, lack of training, and skepticism about the feasibility, effectiveness, and cost-effectiveness of obesity treatment. Additionally, patients with obesity may receive lower quality of care. For example, patients with obesity appear to be less likely to undergo screening for breast and cervical cancer. This application proposes three studies that address important issues in obesity research. First, Dr. Wee plans to test the reliability and validity of a questionnaire she developed that examines the value primary care patients place on weight loss. The quantitative assessment of patient preferences or health values is a way to measure quality of life and is important for clinical decision-making, policy formulation, and formal cost-effectiveness analyses of weight control strategies and recommendations. Dr. Wee then proposes a decision analysis that examines the cost-effectiveness of various weight control strategies and estimates the minimum effectiveness and maximum cost associated with cost-effective treatment. Finally, Dr. Wee proposes to lead the development of a patient and physician directed web-based obesity assessment and education tool in preparation for a subsequent full scale randomized controlled trial. She will examine the feasibility of the intervention, and in a pilot study, determine whether it shows promise by improving the rate and quality of physician counseling about weight control and physical activity. She will also examine its effect on patients' diet and physical activity, patients' stage of change for weight control behaviors, and the rate of cancer screening. This career development award will allow Dr. Wee to acquire additional research skills and experience under the mentorship of nationally and internationally known researchers in a supportive academic environment. Completing these objectives will enhance her ability to conduct patient-centered research and to achieve her career goal of becoming an independent patient-oriented researcher in obesity.
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