The principal investigator of the MOTIVATE Research Lab, Melanie R. Jay, MD, is a leader in obesity and health services research. Learn more about her contributions to the field.

Formative Work

Dr. Jay’s early research evaluated the attitudes and self-reported competency of physicians in treating obesity. After the United States Preventive Services Task Force recommended that physicians counsel patients using a 5As approach (assess, advise, agree, assist, arrange), Dr. Jay evaluated 5As-related skills and competencies (Medicare has since started reimbursing primary care providers for 5As obesity counseling). She found that physicians lacked many 5As skills including assessing diet and providing brief motivational interviewing. Further, many physicians had negative reactions towards patients with obesity and greater skill in patient assessment was associated with less physician discomfort/bias.

Related Publications

Jay M … Kalet A. Do internists, pediatricians, and psychiatrists feel competent in obesity care?: Using a needs assessment to drive curriculum design. J Gen Intern Med. 2008. DOI.

Jay M … Gillespie C. Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study. BMC Health Serv Res. 2009. DOI.

Research on Provider Training and Obesity Counseling

Dr. Jay’s research has since focused on training interventions for providers and integrating 5As obesity counseling into patient centered medical home models of primary care. She has developed a 5As obesity training intervention for primary care providers and tested its impact on physicians’ counseling skills and patient outcomes. This was the first study to show an impact of 5As counseling on patient weight.

More recently, Dr. Jay has been developing interventions to address barriers to 5As counseling that utilize technology and team-based models of care such as Patient Aligned Care Teams (PACT) at the VA NY Harbor Health Care System. Using qualitative methods (interviews with PACT staff and focus groups with patients), Dr. Jay and her team identified barriers and facilitators to obesity counseling and behavior change that informed intervention development.

Related Publications

Jay M … Gillespie C. From the patient's perspective: The impact of training on resident physician's obesity counseling. J Gen Intern Med. 2010. DOI.

Schlair S … Jay M. How medical students' behaviors and attitudes affect the impact of a brief curriculum on nutrition counseling. J Nutr Educ Behav. 2012. DOI.

Acosta A … Lo MC. Improving residents' clinical approach to obesity: Impact of a multidisciplinary didactic curriculum. Postgrad Med J. 2014. DOI.

Mateo KF … Jay M. Development of a tailored, 5A’s-based weight management intervention for Veterans within primary care. 38th Annual Meeting of the Society of General Internal Medicine. J Gen Int Med. 2015.

Development of Technology-Based Interventions in Primary Care

Dr. Jay and her team have evaluated technology-based interventions to facilitate behavior change and improve diet and physical activity in patients. They created an online video and pocket card to help patients better understand the nutrition facts label. The team has conducted usability testing of a VA NY Harbor Healthcare System expert system software application (MOVE!23) in Latina women and veterans. Dr. Jay found that while patients appreciated receiving computer-generated tailored advice, they had difficulty using it to set behavior change goals on their own. This led Dr. Jay to develop the MOVE! Toward Your Goals online tool that is optimized for use with tablet computers and promotes goal setting in patients. This is currently being pilot tested as part of a larger PACT-based intervention to treat obesity at the VA NY Harbor Healthcare System.

Related Publications

Levine DM … Jay M. Technology-assisted weight loss interventions in primary care: a systematic review. J Gen Intern Med. 2014. DOI.

Perez HR … Jay M. “None of them apply to me”: A usability study of the VA’s MOVE!23 online weight management software in Latina Women. 38th Annual Meeting of the Society of General Internal Medicine. J Gen Intern Med. 2014.

Mateo KF … Jay M. Development of an online weight tool to facilitate collaborative goal setting for Veterans in primary care. 38th Annual Meeting of the Society of General Internal Medicine. J Gen Intern Med. 2015.

Barriers and Facilitators to Behavior Change in Underserved Populations

Dr. Jay is interested in exploring causes of obesity and barriers and facilitators to lifestyle behavior change in populations experiencing health disparities. Her team used qualitative methods to explore barriers and facilitators to weight management in Latina women and their experience with goal setting. They also conducted a qualitative metasynthesis to examine Latina food patterns. Dr. Jay has also worked with a team to conduct secondary data analyses of an asthma intervention study to explore the relationships between asthma and obesity in underserved adolescent children.

Related Publications

Jay M … Bruzzese JM. The Relationship between asthma and obesity in urban early adolescents. Pediatr Allergy Immunol Pulmonol. 2012. DOI.

Jay M … Bruzzese JM. Accuracy of weight perception among urban early adolescents with uncontrolled asthma and their caregivers. Ann Behav Med. 2013. DOI.

Gerchow L … Jay M. Latina food patterns in the United States: A qualitative metasynthesis. Nurs Res. 2014. DOI.

Jay M … Kalet A. In our country tortilla doesn't make us fat: Cultural factors influencing lifestyle goal-setting for overweight and obese Urban, Latina patients. J Health Care Poor Underserved. 2014. DOI.