Test the feasibility of integrating evidence based pediatric obesity treatment into medical home model in primary care setting.
Chronic disease management principles were utilized along with electronic medical record (EMR) tools to standardize the process of diagnosis and treatment of pediatric obesity.
We utilized a multidisciplinary team approach in a novel Countdown to Healthy Living program (CHLP), where children and their families were taught to focus daily on the following:
5 servings of fruits and vegetables
4 or more glasses of water
3 cups of low fat milk
2 important meals (breakfast and family dinner)
1 hour of physical activity for 1 hour of screen time
0 sugar sweetened beverages
Phase 1 focused on physician education and developing EMR tools to increase compliance with the existing AAP and the USPSTF clinical practice guidelines, addressing overweight and obesity during well visits.
Phase 2 implemented a family based multidisciplinary pediatric obesity program focused on behavior modification, in partnership with local YMCA.
Children (n=49), ages 6 – 11 years with BMI above 85th percentile, were enrolled for 12 week CHLP family sessions based on behavior based lifestyle change, with the goal of weight maintenance or weight loss. Tools used were barrier identification, goal setting, nutrition counseling and physical activity training.
Education tools (in person training and presentations) as well as questionnaires were used.
80% of physicians reported unfamiliarity with practice guidelines and coding for pediatric obesity. Enrolled families indicated a uniform need for more information about addressing their child's weight issues. Only 18% were confident in their knowledge of a healthy diet and nutrition for their child. Parents and children participating in the program self-reported improved perceived quality of care experience after CHLP. Between January 2011 and June 2012 (CHLP), there was increased documentation of children diagnosed with overweight and obesity (V85.53/ V85.54).Counseling for diet and exercise was documented (V65.3/V65.41) during well visits and recommendations about nutrition and diet were provided in After Visit Summary (AVS)
Physician education is an essential component of timely intervention in diagnosing and managing overweight and obese pediatric patients.
Chronic disease management principles can be applied effectively to pediatric overweight and obesity for improving delivery of evidence based services and standardizing its management in a primary care setting.
- Copyright © 2017 by the American Academy of Pediatrics