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Rosenbaum M, Garofano R, Liimatta K, McArthur K, Paul E, Starc T, Sopher AB, Thaker V, Baidal JW. The Families Improving Health Together (FIT) Program: Initial evaluation of retention and research in a multispecialty clinic for children with obesity. Obes Sci Pract 2021; 7:357-367. [PMID: 34401195 PMCID: PMC8346376 DOI: 10.1002/osp4.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity affects ∼17% of US children, with parallel increases in multiple comorbidities, especially among African-, Asian-, Hispanic-, and Native-Americans. Barriers to patient retention in pediatric obesity programs include lack of centralized care, and frequent subspecialty MD visits which conflict with patient school attendance and parental work attendance as well as with support service utilization. Lack of integration of multispecialty clinical care with interdisciplinary research is a major barrier to fuller exploration of the treatment, prevention, and understanding of obesity in childhood. OBJECTIVE To test the hypothesis, a novel multispecialty/interdisciplinary clinical and research infrastructure with strong emphasis on a primary obesity care physician for children with early-onset (<9 years) obesity (Families Improving health Together [FIT]) could promote lower patient attrition (primary goal) and foster productive research in pediatric obesity (secondary goal). RESULTS Data support the hypotheses. Over 15 months, FIT reported a >90% participant retention (p < 0.001 vs. expected rate based on other studies of similar programs). Though 90% of children had at least one adiposity-related comorbidity and 70% had at least two, there was no need for additional subspecialist visits with cardiologists, endocrinologists, gastroenterologists, or molecular geneticists. Three abstracts were presented at national meetings, and two manuscripts were published all with junior faculty as primary authors. CONCLUSION This pilot study suggests that an integrated multispecialty/interdisciplinary approach to children with obesity improves patient retention and can be integrated successfully with research.
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Affiliation(s)
- Michael Rosenbaum
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Robert Garofano
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Kalle Liimatta
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Kerry McArthur
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Erin Paul
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Thomas Starc
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Aviva B. Sopher
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Vidhu Thaker
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
| | - Jennifer Woo Baidal
- Berrie Diabetes Research PavilionColumbia University Medical CollegeNew YorkUSA
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Recognizing and treating child overweight and obesity. JAAPA 2021; 33:47-50. [PMID: 33234896 DOI: 10.1097/01.jaa.0000721676.28303.7c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary care providers can help prevent and address child overweight and obesity, conditions that can affect children's present and future health as well as their psychologic, emotional, and social well-being. This article describes approaches to preventing, identifying, and addressing overweight and obesity using empathetic, practical, family-focused recommendations and actions.
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Aparicio Rodrigo M, Ruiz Canela J, Buñuel Álvarez JC, García Vera C, Esparza Olcina MJ, Barroso Espadero D, González Rodríguez P, Juanes Toledo B, Martínez Rubio V, Ortega Páez E. Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review. Acta Paediatr 2020; 109:1989-2007. [PMID: 32311805 DOI: 10.1111/apa.15324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/26/2020] [Accepted: 04/17/2020] [Indexed: 11/29/2022]
Abstract
AIM The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care. METHODS MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus. RESULTS Fifty-four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists. CONCLUSION According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors.
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Barlow SE, Salahuddin M, Butte NF, Hoelscher DM, Pont SJ. Improvement in Primary Care Provider Self-Efficacy and Use of Patient-Centered Counseling To Address Child Overweight and Obesity after Practice-Based Changes: Texas Childhood Obesity Research Demonstration Study. Child Obes 2019; 14:518-527. [PMID: 30153036 DOI: 10.1089/chi.2018.0119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Texas Childhood Obesity Research Demonstration project, a multicenter, multisystem approach to childhood overweight and obesity (OW/OB), included training and materials to support primary care clinics (PCCs) in addressing child OW/OB in the office. This study evaluated the impact over 24 months of brief training and practice-based support on primary care providers' (PCPs) perceived self-efficacy and practice behaviors. METHODS The PCPs at five Houston and seven Austin PCCs completed questionnaires at baseline (2012, n = 36), 12 months (2013, n = 30), and 24 months (2014, n = 34) follow-up. Mixed-effects linear regression models were used to compare changes in self-efficacy (15 items, responses 1-4: not at all confident to very confident) and practice behaviors (30 items, responses 0-4: never to always) in obesity-related screening and counseling, and to assess association between prior training and these outcomes. RESULTS Self-efficacy items for identification of (2.9 [0.1] vs. 3.3 [0.1]) and counseling about (2.8 [0.1] vs. 3.4 [0.1]) OW/OB-related parenting practices, and setting behavioral goals (2.9 [0.2] vs. 3.3 [0.2]) improved significantly (p < 0.05) between baseline and 24-month follow-up. Self-efficacy items with "confident" mean baseline scores that further improved included determining child OW/OB (3.6 [0.1] vs. 3.9 [0.1]) and interpreting BMI (3.6 [0.1] vs. 3.9 [0.1]). At all measurements, PCPs reported frequently addressing medical problems and lifestyle behaviors. Use of patient-centered counseling techniques, which was low at baseline, increased significantly, including asking permission before discussing lifestyle (1.5 [0.3] vs. 2.4 [0.3]). Prior training was associated with improved self-efficacy. CONCLUSIONS The improvement in PCPs' self-efficacy and patient-centered counseling to address childhood OW/OB supports implementation of brief training and practice support in clinics that serve Medicaid-eligible children.
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Affiliation(s)
- Sarah E Barlow
- 1 Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital , Houston, TX
| | - Meliha Salahuddin
- 2 Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX.,3 Population Health , Office of Health Affairs, UT System, Austin, TX
| | - Nancy F Butte
- 4 Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center , Houston, TX
| | - Deanna M Hoelscher
- 2 Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas Health Science Center at Houston (UTHealth) , Austin, TX
| | - Stephen J Pont
- 5 Department of Pediatrics, Dell Medical School, Moody College of Communication, Stan Richards School of Advertising and Public Relations, University of Texas at Austin , Austin, TX
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Nasim M, Aldamry M, Omair A, AlBuhairan F. Identifying obesity/overweight status in children and adolescents; A cross-sectional medical record review of physicians' weight screening practice in outpatient clinics, Saudi Arabia. PLoS One 2019; 14:e0215697. [PMID: 31022236 PMCID: PMC6483234 DOI: 10.1371/journal.pone.0215697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND BMI is a feasible and recommended measure for overweight and obesity screening in children and adolescents. The study aimed to determine how often physicians correctly identified obesity/ overweight status in children and adolescents by using BMI percentile charts. METHODS This retrospective cross-sectional study reviewed the paper medical records of children and adolescents (6-14 years) who visited family medicine and pediatric outpatient clinics (Jan-June 2012) in a medical city in Riyadh. Investigators calculated BMI percentiles (using height, weight, age and gender data retrieved from the records) in order to identify patient weight status. Physician documentation of obesity/overweight diagnoses in patient problem lists were cross checked against their BMI percentile to assess the accuracy of physicians' identification of weight status. The recommended management plan for identified patients was also recorded. RESULTS A total of 481 charts were reviewed, 213 (44%) children were seen by family medicine physicians and 268 (56%) by pediatricians. The sample was equally distributed by gender. Height was undocumented for 13% (71) of visiting patients. Eighteen percent of patients (86) were classified as overweight (35)/obese (51) according to age and sex adjusted BMI percentile. Physicians' correctly identified and documented weight status in 20% of overweight/obese patients: 17 out of 86 subjects. Weight status identification was higher among pediatricians-25% as compared to family medicine physicians-10% [p = 0.08]. Dietary referral was the most common management plan for the identified children. Physicians were more likely to identify obese children {≥95th} compared to overweight {≥85th - 95th} children. Subjects whose BMI for age classified them into the highest BMI percentile category {≥95th} were more likely to be correctly identified (29%) compared to those classified within {≥85th - 95th} category-6% [p = 0.007]. CONCLUSION Physician identification of obesity/ overweight status for children and adolescents was low, irrespective of their specialty, and despite the condition being prevalent in the sample. Future research that concentrates on interventions that may improve documentation of obesity/overweight diagnoses and parameters needed for BMI indices would be beneficial.
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Affiliation(s)
- Maliha Nasim
- Department of Population Health, King Abdullah International Medical Research Center/ King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed Aldamry
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Aamir Omair
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fadia AlBuhairan
- Department of Pediatrics and Adolescent Medicine, Aldara Hospital and Medical Center, Riyadh, Saudi Arabia
- John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Nissen T, Wayant C, Wahlstrom A, Sinnett P, Fugate C, Herrington J, Vassar M. Methodological quality, completeness of reporting and use of systematic reviews as evidence in clinical practice guidelines for paediatric overweight and obesity. Clin Obes 2017; 7:34-45. [PMID: 28112500 DOI: 10.1111/cob.12174] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/13/2016] [Accepted: 11/01/2016] [Indexed: 12/18/2022]
Abstract
Paediatric obesity rates remain high despite extensive efforts to prevent and treat obesity in children. We investigated the quality of the methodology and reporting within systematic reviews (SRs) underpinning paediatric content in US clinical practice guidelines (CPGs). In June 2016 we searched guideline clearinghouses and professional organization websites for guidelines published by national or professional organizations in the United States from January 2007 onwards. In our primary, a priori analysis, we used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) instruments to score SRs and meta-analyses that included paediatric populations and were cited by included CPGs. In a secondary, post hoc analysis, we determined the extent to which US CPGs use available, relevant SRs and meta-analyses compared with non-US CPGs. Eight US-based CPGs with 27 references to 22 unique SRs were found. AMSTAR and PRISMA scores were low overall, with only three SRs having 'high' methodological quality. Items dealing with bias assessments and search strategies had especially low scores. US CPGs were also older on average and cited fewer SRs than their international counterparts. Low quality scores and dated guidelines should be a cause for concern among practicing clinicians and a call to action for future guideline developers, publishers and research institutions.
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Affiliation(s)
- T Nissen
- Analytical and Institutional Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - C Wayant
- Analytical and Institutional Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - A Wahlstrom
- Department of Pediatrics, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - P Sinnett
- Analytical and Institutional Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - C Fugate
- Department of Pediatrics, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - J Herrington
- Department of Emergency Medicine, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - M Vassar
- Analytical and Institutional Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Sherwood NE, JaKa MM, Crain AL, Martinson BC, Hayes MG, Anderson JD. Pediatric Primary Care-Based Obesity Prevention for Parents of Preschool Children: A Pilot Study. Child Obes 2015; 11:674-82. [PMID: 26478951 PMCID: PMC4677530 DOI: 10.1089/chi.2015.0009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The Healthy Homes/Healthy Kids Preschool (HHHK-Preschool) pilot program is an obesity prevention intervention integrating pediatric care provider counseling and a phone-based program to prevent unhealthy weight gain among 2- to 4-year-old children at risk for obesity (BMI percentile between the 50th and 85th percentile and at least one overweight parent) or currently overweight (85th percentile ≤ BMI < 95th percentile). The aim of this randomized, controlled pilot study was to evaluate the feasibility, acceptability, and potential efficacy of the HHHK-Preschool intervention. METHODS Sixty parent-child dyads recruited from pediatric primary care clinics were randomized to: (1) the Busy Bodies/Better Bites Obesity Prevention Arm or the (2) Healthy Tots/Safe Spots safety/injury prevention Contact Control Arm. Baseline and 6-month data were collected, including measured height and weight, accelerometry, previous day dietary recalls, and parent surveys. Intervention process data (e.g., call completion) were also collected. RESULTS High intervention completion and satisfaction rates were observed. Although a statistically significant time by treatment interaction was not observed for BMI percentile or BMI z-score, post-hoc examination of baseline weight status as a moderator of treatment outcome showed that the Busy Bodies/Better Bites obesity prevention intervention appeared to be effective among children who were in the overweight category at baseline relative to those who were categorized as at risk for obesity (p = 0.04). CONCLUSIONS HHHK-Preschool pilot study results support the feasibility, acceptability, and potential efficacy in already overweight children of a pediatric primary care-based obesity prevention intervention integrating brief provider counseling and parent-targeted phone coaching. What's New: Implementing pediatric primary care-based obesity interventions is challenging. Previous interventions have primarily involved in-person sessions, a barrier to sustained parent involvement. HHHK-preschool pilot study results suggest that integrating brief provider counseling and parent-targeted phone coaching is a promising approach.
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Affiliation(s)
- Nancy E. Sherwood
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - Meghan M. JaKa
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - A. Lauren Crain
- HealthPartners Institute for Education and Research, Bloomington, MN
| | | | - Marcia G. Hayes
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - Julie D. Anderson
- HealthPartners Institute for Education and Research, Bloomington, MN
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Stovitz SD, Berge JM, Wetzsteon RJ, Sherwood NE, Hannan PJ, Himes JH. Stage 1 treatment of pediatric overweight and obesity: a pilot and feasibility randomized controlled trial. Child Obes 2014; 10:50-7. [PMID: 24410433 PMCID: PMC3922232 DOI: 10.1089/chi.2013.0107] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Staged clinical treatment of pediatric obesity is recommended, but untested. Understanding the lowest intensity stage's effectiveness is necessary for future research. METHODS This was a randomized controlled trial of children ages 4 to <9 years. Participants were recruited after routine evaluations at a primary care pediatric clinic revealed a BMI ≥85th percentile. The intervention was patterned after the "Prevention plus, Stage 1" treatment recommended by an expert committee. Groups were compared for changes, over a 3-month time period, in BMI z-score and parental reports of behavioral issues related to childhood obesity using intent-to-treat (ITT) analysis. RESULTS Seventy-two (30% of eligible) children were enrolled and 64 were remeasured at 3-month follow-up. ITT analysis revealed that both groups improved mean BMI z-score [adjusted change -0.07, control, and -0.04, intervention; 95% confidence interval (CI) of difference=-0.14-0.20]. Over half of the children in each group improved their BMI z-score (adjusted proportion decreasing=55% in control vs. 72% in intervention; 95% CI of difference=-0.07-0.42). The intervention group improved comparatively to the control group on numerous behavioral indicators. CONCLUSIONS Implementation of the lowest intensity stage of current recommendations is feasible and possibly of benefit toward lifestyle changes. Results of this study can be used by future clinical researchers designing protocols to test the full multi-staged approach for the treatment of pediatric overweight and obesity in primary care clinical settings.
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Affiliation(s)
- Steven D. Stovitz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Rachel J. Wetzsteon
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Nancy E. Sherwood
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - Peter J. Hannan
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - John H. Himes
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
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Bartkowiak BA, Safford LA, Stratman EJ. Assessing the impact of a medical librarian on identification of valid and actionable practice gaps for a continuing medical education committee. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2014; 34:186-194. [PMID: 25258131 DOI: 10.1002/chp.21244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Identifying educational needs related to professional practice gaps can be a complex process for continuing medical education (CME) committees and for physicians who submit activity applications. Medical librarians possess unique skills that may be useful for identifying practice gaps relevant to CME committees. We assessed this assumption by assessing a medical librarian's contributions to practice gap identification for the Marshfield Clinic's CME Committee. METHODS We reviewed all locally relevant, locally actionable practice gaps identified annually by various stakeholders and presented to our CME Committee from 2010 to 2013. Total numbers of practice gaps identified, total categorized as actionable, and numbers of subsequent activities resulting from these gaps were calculated for each year. Medical librarian totals were compared to those of other CME committee stakeholders to determine the relative contribution. RESULTS The medical librarian identified unique, actionable published practice gaps that directly contributed to CME activity planning. For each study year, contributions by the medical librarian grew, from 0 of 27 actionable gaps validated by CME Committee in 2010 to 49 of 108 (45.4%) in 2013. With the librarian's assistance, the number of valid practice gaps submitted between 2010 and 2013 by stakeholders climbed from 23 for 155 activities (14.8%) to 133 for 157 activities (84.7%). CONCLUSION Medical librarians can provide a valuable service to CME committees by identifying valid professional practice gaps that inform decisions about educational activities aimed at improving clinical practice. Medical librarians bring into deliberations unique information, including national health policy priorities, practice gaps found in the literature, and point-of-care search engine statistics.
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Wislo VMP, McGaffey A, Scopaz KA, D'Amico FJ, Jewell IK, Bridges MW, Hogan L, Hughes K. Fitwits: preparing residency-based physicians to discuss childhood obesity with preteens. Clin Pediatr (Phila) 2013; 52:1107-17. [PMID: 23814179 DOI: 10.1177/0009922813492012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the Fitwits MD office tool and games for obesity discussions with 9- to 12-year-olds. METHODS A nonrandomized intervention study using pre- and posttest assessments in 2 residency programs compared 31 control group and 55 intervention physicians (34 previously trained, 21 newly trained to use Fitwits). Surveys addressed comfort and competence regarding: obesity prevention and treatment, nutrition, exercise, portion size, body mass index (BMI), and the term "obesity." We surveyed all groups at baseline and 5 months (post 1) and new trainees 3 months later (post 2). RESULTS In post 1, prior trainees reported significantly increased comfort and competence for discussing obesity prevention, portion size, BMI, and "obesity." In post 2, new trainees reported significantly increased comfort and competence discussing obesity prevention and treatment, portion size, and BMI. CONCLUSIONS Experience using Fitwits improved residency-based physician comfort and competence in obesity prevention and treatment, portion size, BMI, and "obesity" discussions with preadolescents.
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Affiliation(s)
- Valerie M P Wislo
- 1University of Pittsburgh Medical Center, St. Margaret Family Medicine Residency Program, Pittsburgh, PA, USA
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Huang JS, Chun S, Sandhu A, Terrones L. Quality improvement in childhood obesity management through the maintenance of certification process. J Pediatr 2013; 163:1313-6.e1. [PMID: 23810127 DOI: 10.1016/j.jpeds.2013.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 04/08/2013] [Accepted: 05/10/2013] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the Health and Obesity: Prevention and Education (HOPE) Curriculum Project, a web-based clinician education program that promotes appropriate screening, prevention, and management of weight among youth by pediatric practitioners, based on the 2007 Expert Committee recommendations. The project currently provides Maintenance of Certification (MOC) Part 4 credit through the American Board of Pediatrics. STUDY DESIGN Participants identified themselves to the HOPE MOC Part 4 program. Enrollees were required to complete all continuing medical education modules (10.5 hours). Knowledge acquisition and self-reported confidence levels related to screening, prevention, and management practices of pediatric obesity were measured using preknowledge and postknowledge questionnaires. Participants were also required to perform a quality improvement project and submit practice performance data from repeated medical chart reviews over time. Knowledge acquisition, self-efficacy, and practice performance data were analyzed using repeated-measures analyses. RESULTS The 51 participants demonstrated significant improvements in knowledge acquisition and self-efficacy scores after viewing individual modules. In addition, participants demonstrated significant improvements in measured clinical compliance with recommended practices over time. CONCLUSIONS Participation in the HOPE MOC Part 4 program appeared to improve knowledge acquisition, self-efficacy, and physician compliance with recommended practice recommendations for the screening, prevention, and management of pediatric obesity. Further data are required to determine whether such practice-based improvements translate into actual reduction in patient weight and/or reduction in health-related costs related to overweight and obesity in youth.
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Affiliation(s)
- Jeannie S Huang
- Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA.
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