Evaluation of High-Interval Education to Improve Outcomes for Bariatric Patients with Health Disparities

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Introduction: Observations were made of post-operative bariatric patients at USA Health who failed to achieve projected weight loss of at least 70% of excess body weight (EBW)as well as frequent loss of patients to clinical follow up. A correlation of health disparities, socioeconomic barriers and health literacy were hypothesized as causative factors of the unsuccessful outcomes. Purpose: This project sought to reveal the health disparities contributing to poor weight loss or weight regain in bariatric surgery patients and explored Nurse Practitioner led interventions supporting the population to achieve optimal outcomes. Methods: This pilot project evaluated quantitative anthropometric 3-month outcome data of an intervention cohort as compared to data collected from retrospective cohort. The intervention cohort participated in pre-operative questionnaire, AAFP Social Needs Screening Tool, to determine health disparities. The intervention cohort participated in weekly education phone calls from the Nurse Practitioner in the first 4-weeks following bariatric surgery. Anthropometric measures were collected during the 3-month clinical evaluation. Results: Quantitative data reveal an average EBW percentage lost at the 3- month post-operative clinical visit of (36.54 ± 0.11, p=0.2929) in the retrospective cohort (n=30) as compare to (33.46 ± 0.11, p=0.2929) of the intervention cohort (N=30). Participants responding to the screening tool reporting barriers did not correspond with the actual needs represented by the population. Those barriers were consistently found to be food access and transportation as factors affecting weight loss. Implications for Practice: This project revealed implications including; the need for development of bariatric specific social needs assessments, the need to explore telehealth as a modality to improve patient education, the need to modify education to overcome deficits in health literacy, and validates the role of the Nurse Practitioner as leaders of multi-disciplinary care teams.

Bariatric surgery, morbid obesity, bariatric education, health disparities