Rates, Variability, and Predictors of Screening for Obesity: Are Individuals with Spinal Cord Injury Being Overlooked?

Obes Facts, 2022 · DOI: 10.1159/000523917 · Published: March 9, 2022

Simple Explanation

This study examines how often veterans with spinal cord injuries (SCI) are screened for obesity using BMI in the VHA system. It's important because obesity is common and can cause other health problems in people with SCI. The study found that a significant number of veterans with SCI are not getting screened for obesity as recommended. Older patients and those with fewer healthcare visits are more likely to be missed. The rates of obesity screening varied greatly between different VHA facilities, suggesting that some facilities are doing a better job than others at screening this population.

Study Duration

FY16-FY19

Participants

20,642 VHA patients with chronic SCI

Evidence Level

Cross-sectional retrospective study

Key Findings

1
A large proportion (37.9%) of persons with SCI receiving care in VHA do not receive guideline-concordant annual obesity screening.
2
Lack of annual obesity screening was significantly associated with older patient age and fewer outpatient encounters.
3
The rate of obesity screening among different facilities within VHA varied widely from 11.1% to 75.7%.

Research Summary

The study aimed to determine the rates, variability, and predictors of guideline-concordant annual screening for obesity among individuals with SCI within the VHA system. The study found that a significant proportion (37.9%) of veterans with SCI do not receive the recommended annual obesity screening, with considerable variation in screening rates across different VHA facilities. Older patients and those with fewer outpatient encounters are more likely to be missed for obesity screening, highlighting the need for targeted interventions to improve screening rates in this vulnerable population.

Practical Implications

Improve Screening Protocols

VHA facilities should review and improve their obesity screening protocols for individuals with SCI, particularly focusing on older patients and those with infrequent outpatient visits.

Address Facility-Level Barriers

Identify and address the facility-level barriers contributing to the wide variation in screening rates across VHA facilities to ensure more consistent and guideline-concordant care.

Further Research

Conduct further research to understand the specific reasons for low screening rates in this population, including challenges in measuring height and weight and provider awareness of obesity risks in SCI patients.

Study Limitations

1
Cross-sectional design limits causal inference.
2
Reliance on administrative data may lead to underestimation of screening rates.
3
Exclusion of low-volume facilities may limit generalizability.

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