Dr. Katia Noyes is Professor and Director of the Division of Health Services Policy & Practice in the School of Public Health & Health Professions, as well as Director of the Surgical Outcomes and Research (UB SOAR) Center in the Department of Surgery (Jacobs School of Medicine and Biomedical Sciences) at the University at Buffalo (UB), USA. She is also the Director of Team Science for UB’s Clinical and Translational Science Institute. She has a broad background in health services research with expertise in health outcomes and quality of care assessment, large administrative data analytics, comparative effectiveness, and economic evaluations in healthcare, as well as mixed methods and implementation research. In the 20+ years of her academic career, she has specialized in the development and evaluation of cross-disciplinary healthcare programs and interventions. Her research explores barriers to care for patients with complex chronic diseases and underserved populations.
One size fits all implementation approach often results in implementation failure in marginalized communities. Obesity is one of the leading causes of preventable death in developed countries. Minority patients bear a disproportionate burden of obesity but are less likely to receive surgical obesity treatment compared to Whites. Evidence indicates that primary care providers (PCPs) rarely able to engage minority male patients in discussion about weight management. The aim of this study is to identify culturally acceptable implementation strategies to disseminate accurate information about surgical weight management in minority men, to help men recognize their weight problem and its consequences, activate them to seek solutions, educate them about the safety and benefits of MBS, to help them locate a high-quality bariatric provider and receive insurance authorization.
The study is conducted in partnership with our community advisory committee (CAC) consisting of stakeholders involved in care, services and decision-making for minority populations. Based on the input from the CAC, we design an educational tool using multiple iterative process obtaining feedback from community stakeholders. We pilot the tool among Black men (n=30) for final feedback and modify the tool to ensure cultural competency, effectiveness and acceptability of the end product. CAC and men are also asked about perceived effectiveness of different implementation strategies (e.g., a cartoon played by Black TV and radio stations vs in Black barber shops).
Our study identified lack of role models for successful surgical weight loss as the most important barriers to Black men’s unwillingness to consider MBS. Black men expressed a strong preference for autonomy when making important health decisions and favored autonomy-preserving approaches to decision making.
New timely and effective strategies are needed to disseminate accurate information about surgical obesity management using patient-centered approaches as well as settings and social connections that patients trust.