Friday, July 15, 2011

Inter-Professional Education in Bariatric Care

A few weeks ago, I posted on a workshop co-organised by the Canadian Obesity Network and the University of Alberta’s Health Sciences Education and Research Commons, on developing a curriculum for inter-professional bariatric care.

The purpose of this project is to build interdisciplinary, interprofessional curricula that can be used by health science faculty and programs for pre-licensure education in obesity.

Barriers to including obesity as a topic in existing curricula include: limited number of experiential learning opportunities available, coupled with broad coverage required; stigma and weight bias, coupled with lack of faculty education/knowledge regarding medical or surgical management of obesity; lack of faculty understanding and acceptance of obesity as a chronic disease; timing and location of obesity content within existing concepts and; the expense of equipment for practical training and limited access to facilities with bariatric patients.

Nevertheless, the following topics were rated as very important to extremely important for students to learn about:

• Weight bias and stigma
• Causes and consequences of obesity
• Obesity prevention
• Obesity treatment
• Adult obesity
• Childhood and adolescent obesity
• Care giving for patients with obesity
• Pregnancy and obesity
• Surgical interventions for obesity

Now the hard work of actually developing and implementing these topics in a curriculum that fits into the already jam-packed curricula of medical, nursing, rehab, pharmacy, psychology and dietetics students begins - no one thinks this will be easy.

A full report of this workshop can is available here.

AMS
Edmonton, Alberta

VN:F [1.5.8_856]
Rating: 10.0/10 (1 vote cast)
VN:F [1.5.8_856]
Rating: 0 (from 0 votes)
  • Share/Bookmark

Friday, July 1, 2011

The Canadian Obesity Network is Nice, Eh?

Given that today is Canada Day, I thought it may be worthwhile to reflect on my past nine years in Canada - particularly on, what I would consider my only real contribution - helpng launch the Canadian Obesity Network (CON).

What many of my readers (and I know several are loyal and enthusiastic network members) may not realise is that, with almost 6000 members, CON is now by far the largest national network of obesity researchers, health professionals, decision makers and other folks with a ‘professional’ interest in obesity anywhere in the world.

In May, the network’s 2nd National Obesity Summit in Montreal drew almost 800 attendees.

To put this in perspective: the US, European, or even the World Congress of Obesity, draw only about two to three times as many attendees.

Considering that Canada’s professional obesity community, is probably proportionally no bigger than elsewhere, one may have expected CON to perhaps have a few hundred members with a few dozen showing up at a Canadian Summit.

So, how do I explain this remarkable ’success’ to my European and US colleagues - who continue to wonder about our ‘magic ingredient’?

I tell them that this meteoritic growth and impact was possible only because Canadians are ‘nice’!

Here’s how the network happened: in 2005 (as a still recent recruit to a Canada Research Chair at McMaster University), I learnt of a call for funding proposals by the federal Networks of Centres of Excellence (NCE) program.

I knew that a lot of excellent obesity research was happening across Canada but also, that there appeared to be very little interaction between researchers or health professionals outside their own field of interest (certainly not an issue unique to Canada).

Of course, the exercise people knew the other exercise people and went to their exercise meetings, the food and nutrition people knew other food and nutrition people and went to their food and nutrition meetings, the public health people went to their public health meetings, the basic science people went to their basic science meetings, the medical people went to their medical meetings - everyone was working away on their own little piece of the ‘elephant’.

Clearly, a ‘network’, that would help connect all these folks and foster an exchange of ideas may provide new solutions to Canada’s emerging obesity epidemic.

But, I did not know the Canadian ‘movers and shakers’ in obesity — the people I would need to include, if this proposal was to stand even a remote chance of success (the NCE is one of the most competitive funding programs in Canada).

After a few hours online, I came up with a list of about a 100 researchers, who, based on their recent publications, apparently had an interest in obesity - on diverse topics ranging from cell biology to city building and school programs to bariatric surgery).

I sent each of them a friendly e-mail, introducing myself and floating the idea of applying for funding to create a ‘Canadian Obesity Network’. The submission deadline was about five weeks away, but hey, if enough people thought this was a good idea, I’d be happy to take the lead and hammer out the proposal.

Imagine my surprise when within hours of sending out this request, virtually everyone responded wanting ‘in’ and asking how they could help.

I had not offered them money (it would only have been a measly $4000 per applicant, had I simply offered to give each one their share of the funding pie).

I had not presented a detailed outline of what the network would actually do (I wasn’t so sure myself).

I had never met most of these people and I am sure most had never heard of me.

But perhaps, I was most surprised, because, back in Germany (where I came from), any such response would have been unimaginable - my colleagues from around the world assure me that, a similar approach in their countries would also have elicited a few luke warm responses if any.

And yet, here in Canada, it was hard not to be overwhelmed by the enthusiasm.

Not wanting to write the proposal alone, I asked the teenage son of a colleague to set up a ‘Wiki’ and invited everyone to go online and write a paragraph or two about themselves and what they thought this network should be about — and they did!

Within hours, I had 100s of lines of text from people, who freely shared their ideas and enthusiasm (back in 2005 Wikis and ‘crowd sourcing’ were yet to become buzzwords).

But I needed more from them — I wanted them to go to their Deans and department Chairs for letters of support, signatures, and to solicit tangible commitments in support of this proposal — so I was asking for actual work.

Again, within days, letters and signed forms from universities across Canada began appearing in my in-box.

So the researchers were on board — but that was not enough.

We also needed support from a wide range of other ’stakeholders’ — professional associations, industry, government and non-government organizations.

So, I sent out another set of e-mails and once again the response was enthusiastic. Within days, I had over 120 letters of support from across Canada.

In the meantime, I sketched an outline of what I though may be a reasonable logo (it had to of course involve a maple leaf) and took it to the university’s graphic design people, who crafted the logo (including the rather fine ‘Canadian’ touch of the measuring tape on the logo being in centimetres and not inches).

We set up a website and let people, who began coming out of the woodwork, sign up to ‘join’ the network in exchange for telling us who they were and what their ‘professional’ interest in obesity was — hundreds signed up within the first few weeks (even before we submitted our application).

To cut to the chase, Canadians from St. John’s to Victoria bought into the idea, donated their time, shared their ideas, wrote letters, responded to e-mails, filled out forms, dialled into conference calls and more. All this over the summer months of July and August, where any self-respecting Canadian should be out camping or relaxing at their cottage.

A similar response, speaking to colleagues around the world, would have been unimaginable anywhere but Canada (and I’d be happy to be proven wrong!).

Membership in the network is free, anyone with a professional interest in obesity can join simply by registering at www.obesitynetwork.ca.

Members receive newsletters, access to obesity management tools and other resources, and become part of Canada’s professional obesity community.

To date CON has trained over 3000 health professionals and has hosted regional and national workshops on everything from built environments to weight-bias and discrimination (the latter event garnering over 40 million media impressions worldwide).

CON’s capacity building initiatives support Student Chapters at Canadian univerisities, an annual Obesity Student Bootcamp (to teach graduate students about obesity — not to lose weight!), and national student conferences. There is now a tightly woven sub-network of over 1000 students and young professionals with a keen interest in obesity prevention and management.

The network also supports national initiatives to address childhood obesity and works closely with the Canadian Institutes of Health Research to define a research agenda to support health care for Canadian kids and adults struggling with excess weight.

It has brought together provincial and territorial decision makers to develop obesity strategies and has partnered with the Public Health Agency of Canada on guidelines and tools for obesity management in primary care.

In just five short years, on what many would consider a ’shoe-string’ budget (the network has only three full-time staff - I ‘volunteer’ my time), CON has rallied a diverse community of obesity researchers, health professionals, decision makers and other stakeholders behind it to transform the professional obesity landscape in Canada at a pace that has other countries asking how Canada did this.

Of course, even these efforts have yet to have a noticeable impact on preventing and reducing the burden of obesity on the mental, physical and economic health of Canadians - a burden that is conservatively estimated to be about $20-50 billion annually (and growing).

For the network to continue and further expand its work, it will need substantially more support and funding - the enthusiasm of its members is clearly not a rate-limiting factor here. Several forward-thinking corporations and organisations have stepped up to partner with the network - more need to do so.

Clearly, much remains to be done and all who would like to join and support these activities are more than welcome to put their weight behind this network (pun intended).

I, for one, am proud to be part of this journey and am thankful to be in Canada to do this.

If the Canadian Obesity Network is anything — it is truly Canadian.

Happy Canada Day!

AMS,
Edmonton, Canada

VN:F [1.5.8_856]
Rating: 10.0/10 (6 votes cast)
VN:F [1.5.8_856]
Rating: +8 (from 8 votes)
  • Share/Bookmark

Tuesday, June 28, 2011

Inter-Professional Education in Bariatric Care

Even casual readers of these pages will by now have realised that obesity prevention and management is much more than “Eat-Less-Move-More” and can only be successfully tackled by an inter-disciplinary approach based on a complex chronic care model that appreciates the heterogeneity of this condition.

But bariatric competencies are not just required by health professionals involved in the prevention or treatment of this condition.

Because obesity now affects a quarter or the adult population, every health professional is likely to be called upon to deliver health care to people (both adults and kids) with excess weight.

This means, that all health professionals (from dentists to forensic pathologists) will need to have at least a minimal understanding of the complex socio-psycho-biology of this condition and how to respectfully and professionally deal with individuals presenting with excess weight.

This was the topic of a meeting that I attended yesterday co-organised by the Canadian Obesity Network and the Health Sciences Education and Research Council (HSERC) of the University of Alberta.

The meeting included representatives from both the University of Alberta as well other post-secondary institutions that train health professionals like Grant MacEwan University as well as representative across faculties and disciplines including public health, nursing, rehabilitation, nutrition, pharmacy, and medicine.

The workshop was also attended by representatives from Alberta Health Services, who expressed their dire need for more health professionals better trained in all aspects of bariatric care.

The focus of the meeting was to discuss how to integrate a minimum knowledge set and clinical competencies into the curricula across these various disciplines but also how to foster inter-professional learning and practice in a manner consistent with the complex and heterogeneous nature of bariatric care.

It was evident that all faculties recognise that there are significant gaps in current curricula and that few faculties have enough time or resources dedicated to educating their students on this issue.

It was also evident that for many faculties the key challenge may start with educating the faculty itself on obesity before we can expect them to begin teaching the essentials of obesity prevention and management to their students.

Based on the discussions at this workshop, it is evident that this may not be a problem unique to the universities at the table, and that similar initiatives may need to be launched and supported by the Canadian Obesity Network at universities across Canada.

Given the enthusiasm and the discussions at this workshop, I am hopeful that coming generations of health professionals across disciplines may well have a far better understanding of this complex condition and most importantly (if nothing else) be qualified and positioned to take a sensitive, professional and non-judgmental approach to dealing with obesity in their clients.

A full report on this workshop will be released shortly and made available through the Canadian Obesity Network.

AMS
Edmonton, Alberta

VN:F [1.5.8_856]
Rating: 10.0/10 (2 votes cast)
VN:F [1.5.8_856]
Rating: +3 (from 3 votes)
  • Share/Bookmark

Wednesday, June 22, 2011

Vote of Thanks!

This week, I was very much humbled and honored to receive an honorary Doctor of Science degree from the University of Guelph-Humber.

I do not want to reiterate my sincere words of thanks to the University of Guelph-Humber (particularly to Michael O’Leary. Program Head - Kinesiology) or repeat my two cents of advise that I gave to the graduates of the kinesiology, computing, psychology and media programs.

(click here to view the news release and address)

I do, however, wish to once again thank all of my mentors, teachers, colleagues and, most of all, my patients and students, from whom I continue to learn everyday.

I am grateful to my parents, my family, my friends, who, as I say in my address, “do not consider anything I do real work - as I always seem to be having way too much fun“.

I am grateful to all of you, who are members and supporters of the Canadian Obesity Network, for your continuing engagement and enthusiasm - together we can challenge what needs to be challenged, research what needs to be researched, learn what needs to be learnt, change what needs to be changed, improve what needs to be improved, and, most importantly, do what needs to be done to improve the health and well-being of those challenged by excess weight.

And, to you my readers - your many comments continue to force me to think in new directions and appreciate different perspectives of this complex problem.

Thank you all for your unwavering support.

AMS
Edmonton, Alberta

VN:F [1.5.8_856]
Rating: 9.8/10 (6 votes cast)
VN:F [1.5.8_856]
Rating: +7 (from 7 votes)
  • Share/Bookmark

Monday, June 6, 2011

Plate or Pyramid - Why Nobody Really Cares About Nutrition Guides

Last week, the USDA abandoned its long-favoured and iconic Food Pyramid and replaced it with a plate.

One key motivator, according to the press release, which includes enthusiastic quotes from Michelle Obama and Agriculture Secretary Tom Vilsack, is that a ‘new generation’ icon is needed to better help Americans make healthier food choices.

This new icon is the centrepiece of the new ChoseMyPlate website which,

provides practical information to individuals, health professionals, nutrition educators, and the food industry to help consumers build healthier diets with resources and tools for dietary assessment, nutrition education, and other user-friendly nutrition information.

Whether this new icon or even this website will really have anyone paying attention is doubtful - because there is one fundamental problem with all nutrition guides - they focus on nutrition!

The following brief video may explain exactly what I mean (readers may have to visit my site to see it).

In short, if we don’t solve the taste, cost, and convenience problem - no guide will change our eating habits.

Strategies based on trying to educate people to simply “eat-less and move-more” (ELMM) do not work for individuals - they will also not work for populations.

Effective strategies, both for individuals and populations, will unfortunately need to address the ‘real’ reasons why people eat too much and are not moving enough.

AMS
Edmonton, Alberta

VN:F [1.5.8_856]
Rating: 9.6/10 (9 votes cast)
VN:F [1.5.8_856]
Rating: +12 (from 14 votes)
  • Share/Bookmark
In The News

Tax ‘toxic’ sugar, doctors urge

Feb. 6, 2012 CBC – "I don't think we can bring the whole question about obesity down to a simple substance like people eating too much sugar," Sharma said in an interview from Lethbridge, Alta. Read the article

» More news articles...

Publications

  • 2011 Canadian Weblog Awards
  • Subscribe via Email

    Enter your email address:


    Delivered by FeedBurner
  • http://www.wikio.com
  • I Twitter!


  • Disclaimer

    Postings on this blog represent the personal views of Dr. Arya M. Sharma. They are not representative of or endorsed by Alberta Health Services or the Weight Wise Program.

  • 2nd place best health blog

    • Recent Posts

    • Archives

    • RSS Weighty Matters

    • RSS Dr Eye Candy

    • Click for related posts

    • Disclaimer

      Medical information and privacy
      Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.


    • Meta

    • Obesity Links

      • Average blog rating:

        9.0


      • Home | KOL | Media | Research | Publications | Trainees | Patients
        Copyright 2008 Dr. Arya Sharma, All rights reserved.
        Blog Widget by LinkWithin