Research

Working together with front line healthcare providers, the research team developed an intervention aimed at changing provider behaviour around obesity prevention and management. The intervention was found to be effective in addressing provider-identified gaps and lead to increased confidence in conducting obesity assessments and interdisciplinary work. Integration of new knowledge required that providers change their own mental models of their practice and increased success was achieved when the entire team developed a new way of working together to integrate their different roles to support patients and each other. This work has resulted in the 5AsT toolkit which consists of tools and resources to help support clinicians in their practice.

• Campbell-Scherer DL, Asselin J, Osunlana AM, Fielding S, Anderson R, Rueda-Clausen CF, Johnson JA, Ogunleye AA, Cave A, Manca D, Sharma AM. Implementation and evaluation of the 5As framework of obesity management in primary care: Design of the 5As team (5AsT) randomized control trial. Implementation Science, 2014; 9:78-87. https://doi.org/10.1186/1748-5908-9-78
• Osunlana AM, Asselin J, Anderson R, Ogunleye AA, Cave A, Sharma AM, Campbell-Scherer DL. 5As Team obesity intervention in primary care: development and evaluation of shared-decision-making weight-management tools. Clinical Obesity, 2015; 5(4): 219-25. https://doi.org/10.1111/cob.12105
• Asselin J, Osunlana AM, Ogunleye AA, Sharma AM, Campbell-Scherer DL. Missing an opportunity: The embedded nature of weight management in primary care. Clinical Obesity, 2015 Dec; 5(6):325-32. https://doi.org/10.1111/cob.12115
• Ogunleye AA, Osunlana AM, Asselin J, Anderson R, Cave A, Sharma AM, Campbell-Scherer DL. The 5As Team intervention: Bridging the knowledge gap in obesity management among primary care practitioners. BMC Research Notes, 2015 Dec 22; 8:810. https://doi.org/10.1186/s13104-015-1685-8
• Asselin J, Osunlana AM, Ogunleye AA, Sharma AM, Campbell-Scherer DL. Challenges in interdisciplinary weight management in primary care: Lessons learned from the 5As Team (5AsT) study. Clinical Obesity, 2016; 6(2): 124-32. https://doi.org/10.1111/cob.12133
• Asselin J, Salami E, Osunlana AM, Ogunleye AA, Cave A, Johnson JA, Sharma AM, Campbell-Scherer DL. Impact of the 5As Team study on clinical practice in primary care obesity management: A qualitative study. CMAJOpen, 2017; 5(2): E322-9. https://doi.org/10.9778/cmajo.20160090
• Luig T, Asselin, J, Sharma AM, Campbell-Scherer DL. Understanding implementation of complex interventions in primary care teams. JABFM, 2018; 31(3), 431-44. https://doi.org/10.3122/jabfm.2018.03.170273
• Campbell-Scherer DL, Asselin J, Osunlana AM, Ogunleye AA, Fielding S, Anderson R, Cave A, Johnson J, Sharma AM. Changing provider behaviour to increase chronic disease nurse visits for obesity in family practice: The 5AsTeam randomized control trial. CMAJOpen. 2019 May; 7(2):E371-378. https://doi.org/10.9778/cmajo.20180165

The 5AsT-MD project was designed to create, evaluate, and refine a comprehensive educational program for medical residents. The course integrated didactic instruction, hands-on experiential learning, and clinical practice to enhance learners' understanding of obesity’s complexity and pathophysiology. It also offered an overview of treatment strategies, tools, and resources to support the care of patients living with obesity. Evaluation of the pilot demonstrated that residents gained a deeper appreciation for the chronic and multifaceted nature of obesity and reported increased confidence in their weight management skills. The course is now part of residency training in family medicine, pediatrics, psychiatry, and internal medicine at the University of Alberta. Under the leadership of Dr. Sonja Wicklum, it has also been incorporated into the family medicine residency program at the University of Calgary. Additionally, the course has been offered as Continuing Professional Development for practicing physicians and interdisciplinary healthcare providers.

• Luig T, Wicklum S, Heatherington M, Vu A, Cameron E, Klein D, Sharma AM, Campbell-Scherer DL. Improving obesity management training in family medicine: multi-methods evaluation of the 5AsT-MD pilot course. BMC Medical Education, 2020; 20(5): 1-11. https;//doi.org/10.1186/s12909-019-1908-0

The research team explored patient perspectives on the role of primary care in obesity management in an effort to better understand what patients want and to develop more effective management strategies. Findings of this qualitative study revealed patients want their family physician to have these discussions with them and they want to have a personalized assessment and plan.

• Torti J, Luig T, Borowitz M, Johnson JA, Sharma AM, Campbell-Scherer DL. Patient perspectives on the role of primary care in obesity management. BMC Family Practice, 2017; 18(10):1-10. https://doi.org/10.1186/s12875-017-0596-2

In this project we partnered with patients and healthcare providers to explore how to achieve personalized, meaningful conversations about obesity. The goal was to develop an approach to obesity assessment and care planning that builds on a shared understanding of patients’ lives and supports people in improving health. We observed patient-provider encounters and explore their experiences of the encounter and everyday impacts through interviews and patient journals. We learned that it was important for providers and patients to explore the patient’s story together to make sense of root causes, life circumstances, and emotional aspects of living with obesity. Participants found helpful to orient their care plan on improving whole-person health, recognizing their strengths, learning about the complexity of obesity, and collaboratively planning actions that meaningfully fit with their lives. Through this process patients experienced more hope, confidence, and success in making changes to improve health.

• Luig T, Anderson R, Sharma AM, Campbell-Scherer DL. Personalizing obesity assessment and care planning in primary care: Patient experience and outcomes in everyday life and health. Clinical Obesity, 2018; 8(6): 411-423. https://doi.org/10.1111/cob.12283
• Luig T, Elwyn G, Anderson R, Campbell-Scherer DL. Facing obesity: Adapting the collaborative deliberation model to deal with a complex long-term problem. Journal of Patient Education and Counseling. 2019; 102(2):291-300. doi: 10.1016/j.pec.2018.09.021. https://doi.org/10.1016/j.pec.2018.09.021
• Luig T, Keenan L, Campbell-Scherer DL. Transforming health experiences and action through shifting the narrative on obesity in primary care encounters. Qualitative Health Research. 2020; 30(5):730-44. https;//doi.org/10.1177/1049732319880551

Building on our research around personalized, collaborative consultations, this project focused on refining some of the existing tools developed by the 5As Team research program to support collaborative conversations between patients and care providers. A co-design approach was used to improve the efficacy and applicability of the tools. We used personas, role playing, dialogue prompters, and prototypes to foster collaboration and communication between patients, health professionals and researchers. The tools need to help us understand the uniqueness and complexity of each case: the person behind the medical conditions. The tools should foster iterative inquiry to understand the patient’s circumstances to tailor treatment and care.

• Noël G, Luig T, Heatherington, M, & Campbell-Scherer DL. Developing tools to support patients and healthcare providers when in conversation about obesity: The 5As Team Program. Information Design Journal, 2018; 24(2):131-150. https://doi.org/10.1075/idj.00004.noe
• Noël G, Luig T, Campbell-Scherer DL. Creating caring conversations for patients living with obesity. The 5As Team program. Extract of the Proceedings of the 5th International Conference on Design4Health, 2018. Available at https://research.shu.ac.uk/design4health/wp-content/uploads/2018/09/683.pdf

Dr. Denise Campbell-Scherer served on the Executive Committee of the 2020 Canadian adult obesity clinical practice guidelines which were published by Obesity Canada in collaboration with the Canadian Association of Bariatric Physicians and Surgeons (CABPS). Dr. Campbell-Scherer was also involved in a pilot project to adapt these guidelines in both Ireland and Chile.

• Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: a clinical practice guideline. CMAJ, 2020;192(31): E875-E891. https://doi.org/10.1503/cmaj.191707
• Campbell-Scherer D, Walji S, Kemp A, Piccinini-Vallis H, Vallis T. Canadian adult obesity clinical practice guidelines: Primary care and primary healthcare in obesity management. Obesity Canada Website, 2020: 1-14. https://obesitycanada.ca/guidelines/chapters/
• Ramos Salas X, Contreras MAS, Breen C, Preiss Y, Hussey BF, Forhan M, Wharton S, Campbell-Scherer D, Vallis M, Brown J, Pedersen SD, Sharma AM, Woodward E, Patton I, Pearce N. Review of an international pilot project to adapt the Canadian adult obesity practice guideline. Obesity Pillars, 2023;8: 1-7. https://doi.org/10.1016/j.obpill.2023.100090

Existing care structures fail to meet the needs of ethnocultural newcomer communities, where immigration stress, poverty, and social barriers contribute to rising rates of obesity and diabetes. To address this, we co-developed this project with the Multicultural Health Brokers Cooperative (MCHB) and partnered with the Edmonton Southside PCN to explore chronic disease management challenges. Through participatory action research, we engaged community members, cultural brokers, primary care providers, and policymakers to identify barriers and solutions. Key findings showed that pre- and post-immigration stress hinders chronic disease management, and cultural brokers play a crucial role in bridging care gaps. A data dashboard was developed with the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) to help physicians identify at-risk patients based on social and material deprivation. Additional resources were created to assist community brokers and healthcare providers in navigating support services.

• Ofosu NN, Luig T, Chiu Y, Mumtaz N, Yeung RO, Lee KK, Wang N, Omar N, Yip L, Aleba S, Maragang K, Ali M, Dormitorio I, Campbell-Scherer DL. Understanding the bigger picture: Syndemic interactions of immigrants and refugee context with the lived experience of diabetes and obesity. BMC Public Health, 2022;22(345): 1-12. https://doi.org/10.1186/s12889-021-12305-3
• Luig T, Ofosu NN, Chiu Y, Wang N, Omar N, Yip L, Aleba S, Maragang K, Ali M, Dormitorio I, Lee KK, Yeung RO, Campbell-Scherer DL. The role of cultural brokering in advancing holistic primary care for diabetes and obesity: a participatory qualitative study. BMJ Open, 2023;13(9): 1-12. dx. https://doi.org/10.1136/bmjopen-2023-073318
• Ofosu NN, Luig T, Mumtaz N, Chiu Y, Lee KK, Yeung RO, Campbell-Scherer DL. Healthcare providers’ perspectives on challenges and opportunities for intercultural healthcare in diabetes and obesity management: a qualitative study. CMAJ Open, 2023;11(4): E765-73. https://doi: doi.org/10.9778/cmajo.20220222

• Campbell-Scherer DL, Sharma AM. Improving obesity prevention and management in primary care in canada. Current Obesity Reports, 2016; 5(3): 1-6. https://doi.org/10.1007/s13679-016-0222-y
• Sharma AM, Campbell-Scherer DL. Redefining obesity: Beyond the numbers. Obesity, 2017; 25:4, 660-1. https://doi.org/10.1002/oby.21801
• Sturgiss E, Jay M, Campbell-Scherer DL, van Weel C. Challenging assumptions in obesity research. BMJ, 2017;359: j5303. https://doi.org/10.1136/bmj.j5303
• Swaleh R, McGuckin T, Myroniuk TW, Manca D, Lee K, Sharma AM, Campbell-Scherer D, Yeung RO. Using the Edmonton Obesity Staging System in the real world: A feasibility study. CMAJ Open, 2021;9(4): 1141-8. https://doi.org/10.9778/cmajo.20200231
• Ells L, Ashton M, Li R, Logue J, Griffiths C, Torbahn G, Marwood J, Stubbs J, Clare K, Gately P, Campbell-Scherer D. Can we deliver person-centred obesity care across the globe?. Current Obesity Reports, 2022;11: 350-355. https://doi.org/10.1007/s13679-022-00489-7
• Campbell-Scherer DL. New insights and future directions: the importance of considering poverty in studies of obesity and diabetes. Annals of Family Medicine, 2023;21(3): 205-6. https://doi.org/10.1370/afm.2983
• Mytton OT, Campbell-Scherer D, Reckless I, Llewellyn C. Diagnosing and defining obesity. BMJ. 2025. https://doi.org/10.1136/bmj.r460