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
