Allen Strickler

Susan Cluett

Paige Hornsby

MPH Presentation

22 April 2011

ADDRESSING THE CURRENT PEDIATRIC OBESITY EPIDEMIC

THROUGH HEALTH CARE PROVIDER EDUCATION

OBJECTIVES

• Introduction to the pediatric obesity problem

• Project: Practice gaps of Health Care Providers (HCP) in Virginia

• Address practice gaps: Learning Materials

• Conclusions, lessons learned, and future directions

INTRODUCTION

• Pediatrics overweight/obesity defined by BMI (kg/m2):

• overweight: 85-94 percentile, obese: >95 percentile

• Relatively new problem. Rate of overweight/obese increased from 4-5% in the 1960’s to approximately 16-20% currently.

• Affects all groups. Disparities

SIGNIFICANT HEALTH ISSUE

http://www.obesityhelp.com

WHAT CAN BE DONE?

• Address current problems and origins of problems

• Children’s Fitness Clinic (CFC)

• HCPs role instituting change: Practice gaps in Identification, management, referrals, and evaluation.

OUR PROJECT

• Develop learning materials in CME and online toolkit form

• Multi-mode survey questionnaire to address practice gaps

• 310 HCP’s in CFC catchment area

• QuestionPro

QUESTIONNAIRE RESULTS

• Completion rate: 70/310 (23%)

• Question categories: HCP characteristics, practices, CFC specific, open-ended

• Analyzed data in QuestionPro

• Cross tabulation

CHARACTERISTICS

PRACTICES

PRACTICES

CFC SPECIFIC

CFC SPECIFIC

OPEN-ENDED QUESTION RESPONSES

CROSS TABULATION

CROSS TABULATION

CME MODULE AND TOOLKIT

• General areas of focus:

• Identification: BMI checks (FM)

• Management: Comorbidities

• Referrals: Timing

• Evaluation: Success Metrics

• CME Module: General Management and Referrals, Motivational Interviewing

• Online Toolkit: Comorbidity Management

CONCLUSIONS AND LESSONS LEARNED

• Practice gaps exist in identification: ID, management, referral, evaluation

• Questionnaire results will help us develop learning materials

• Importance of ‘subjective’ vs ‘objective’ data

THE FUTURE• Our Project

• Evaluation of learning materials

• Second survey

• Chart study

• Pediatric Obesity

• Problems and origins of those problems

• Move from ‘treatment’ to ‘prevention’

REFERENCES

• “Obesity in Children and Adolescents: Guidelines for Prevention and Management”, 2004, http://findarticles.com/p/articles/mi_qa3958/is_200408/ai_n9454138/.

• Cynthia L Ogden and Katherine M Flegal, “Changes in terminology for childhood overweight and obesity,” National Health Statistics Reports, no. 25 (June 25, 2010): 1-5.

• Manu Raj and R. Krishna Kumar, “Obesity in children & adolescents” 132, no. 5 (November 2010): 598-607.

• Jeffrey J VanWormer and Jackie L Boucher, “Motivational interviewing and diet modification: a review of the evidence,” The Diabetes Educator 30, no. 3 (June 2004): 404-406, 408-410, 414-416 passim.

• Tracy Hampton, “Pediatric Obesity Guidelines Released,” JAMA: The Journal of the American Medical Association 300, no. 19 (November 19, 2008): 2238.

• http://www.epharmacies.com/online-pharmacy-medicine-blog/blood-pressure-medicine-for-children-a-good-idea/

• http://www.obesityhelp.com/forums/teen_wls/cmsID,11323/mode,content/a,cms/

• http://uvahealth.com/directions-locations/clinics/childrens-fitness-clinic/childrens-fitness-clinic