A special session organized by the Diabetes Primary Care Alliance of the American Diabetes Association^® (ADA) will feature a trio of speakers who will discuss ways the ADA is supporting efforts to improve primary care practices for diabetes through overcoming weight bias, improving pharmacy connections, and optimizing access to technology.

The panel discussion, Implementing Improvements in Care Delivery, will be held on Saturday, June 21, from 1:30–3:00 p.m., in Room W183 BC of the McCormick Place Convention Center.

Jack Westfall, MD, MPH, Vice President of Medical Affairs at the DARTNet Institute, will discuss an ongoing pilot project designed to reduce obesity bias and stigma in primary care.

“We know that stigma related to weight is a real barrier to weight management,” Dr. Westfall said. “There are all sorts of reasons for it, starting with the language in the medical literature, which is often very judgmental and pejorative. We call people ‘fat,’ we use terms like ‘morbid obesity,’ and we just don’t have a good sense of how to start conversations about weight with our patients, who are often ashamed or embarrassed to talk about it.”

Because most of the care for people with diabetes occurs in the primary care setting, Dr. Westfall said it is important that primary care practices understand the impact that both implicit and explicit bias can have on their ability to incorporate weight management into disease management.

“That is the impetus for the educational pilot program we are doing in 50 primary care practices across the High Plains Research Network, mostly in rural Colorado,” Dr. Westfall said. “The program is a 90-minute intervention, which takes place in the participating practices and includes a brief video presentation about weight stigma, bias, the language we use, and how a practice may be set up to be more comfortable for somebody who is overweight.”

The video is followed by discussion among the practice staff and coaching from a practice facilitator.

“And, importantly, everyone among the practice staff is included—doctors, nurses, advanced practice clinicians, medical assistants, as well as front-office and back-office staff—because total team care is the way of health care, particularly primary care, and particularly for chronic conditions like overweight, obesity, and diabetes,” Dr. Westfall said.

The program also includes recommendations for changes and adjustments to consider related to the physical space of the practice.

“Practices are often set up with an implicit bias against people who are overweight. For example, chairs in the waiting room and exam rooms may have arms on them that are too narrow, making them hard for some people to fit in, and often a clinic’s intake scale is right in the hallway where anybody can see what your patient’s weight is when they walk by,” Dr. Westfall said. “We simply have to do a better job of making our practices a safe place for people to have conversations around their weight.”

Moving forward, he said he and his colleagues are working on plans to take what they’ve learned in this pilot project and work with the Diabetes Primary Care Alliance to bring the program to as many as 500 practices.

“This is about teaching practices to practice 21^st century weight management, and I think we’ve shown that even a brief intervention, 90 minutes in a practice, can improve the conversation around weight,” Dr. Westfall said. “Just giving people a little bit of knowledge can stimulate them to think about how they can address overweight bias, overcome the stigma, and improve the care they provide their patients.”

Also during this session, Sandra Leal, PharmD, MPH, CDCES, American Pharmacists Association, will discuss pharmacy support in primary care, and Manmohan K. Kamboj, MD, Nationwide Children’s Hospital at The Ohio State University, will talk about optimizing type 1 diabetes care access to diabetes technology.

On-demand access to recorded presentations will be available to registered participants following the conclusion of the 85^th Scientific Sessions, from June 25–August 25.