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Reschke F, Galuschka L, Landsberg S, Weiner C, Guntermann C, Sadeghian E, Lange K, Danne T. Successful telehealth transformation of a pediatric outpatient obesity teaching program due to the COVID-19 pandemic - the "Video KiCK" program. J Pediatr Endocrinol Metab 2022; 35:803-812. [PMID: 35575788 DOI: 10.1515/jpem-2022-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/22/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate if digital approaches can ameliorate the known consequences of social-distancing restrictions in the context of the global COVID-19 pandemic for adolescent participants originally registered for a face-to-face outpatient weight regulation program and whether video-based multiprofessional outpatient obesity therapy is successful for a group of adolescents with preexisting obesity. METHODS The certified KiCK outpatient training program for children and adolescents with overweight and obesity was remodeled as a consequence of the lockdown traditional face-to-face program to a completely digital and video-based format on short notice. The virtual approach was compared with the results of the conventional program regarding metabolic parameters, body mass index standard deviation score (BMI SDS), well-being, and physical fitness. RESULTS Sixty-nine of 77 enrolled participants for KiCK (age 8 to 17 years, BMI z score >2.0) were able and willing to participate virtually. After the first lockdown significant improvements of BMI SDS (mean 0.18; p=0.02), homeostasis model assessment (HOMA) index (mean 1.4; p=0.016), triglycerides (mean 0.18 mmol/dL; p=0.021), 6 minute-walk-test (mean 97.0 m; p=0.030, and well-being according to the World Health Organization 5 (WHO-5) questionnaire (mean 2.5; p=0.002) were found after the virtual intervention, which was comparable to the results observed previously in matched pairs data from the program during the pre-COVID period. After the end of the second lockdown weight SDS, BMI SDS, HOMA INDEX, and cholesterol were also measured reduced compared to baseline parameters measured before program initiation. Walking distance in the 6 MWT and improvement in general well-being in the WHO-5 questionnaire also persisted. CONCLUSIONS These results indicate good acceptance and efficacy of the video-intervention for youth with overweight and obesity during the lockdown, supporting the use of virtual modules in future programs after the pandemic.
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Affiliation(s)
- Felix Reschke
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Laura Galuschka
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Sarah Landsberg
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Chantal Weiner
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Cathrin Guntermann
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Evelin Sadeghian
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
| | - Karin Lange
- Medical Psychology, Hannover Medical School, Hannover, Germany
| | - Thomas Danne
- KiCK - Initiative, Center for Diabetology and Endocrinology for Children and Adolescents, Children`s Hospital Auf Der Bult, Hannover, Germany
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Espinola DC, Olsen C, Banaag A, Koehlmoos TP. A Cohort Study Comparing Pediatric Patients with Overweight and Obesity in the Military Health System. Child Obes 2021; 17:476-482. [PMID: 34081542 PMCID: PMC8568786 DOI: 10.1089/chi.2021.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: National Health and Nutrition Examination Survey data from the 1960s to 2010s confirm that pediatric obesity rates are increasing. To assess obesity in the Military Health System (MHS), we evaluated a pediatric cohort's trends in BMI categorization from 2009 to 2016. Methods: We identified two age-based pediatric cohorts in the United States using the MHS Data Repository. We tracked them for BMI from 2009 to 2016. We calculated BMI percentiles and z-scores using validated growth charts, and biologically implausible BMI z-scores were removed from analyses. Using the Stuart-Maxwell test, we assessed the percent change in BMI categorization from 2009 to 2016 and stratified by age group. Results: Our cohort consisted of 130,675 pediatric patients (52.2% males and 47.8% females). The proportion in each BMI categorization changed significantly from 2009 to 2016 in all groups (p < 0.001). Increases in the Overweight and Moderate or Severe Obesity categories were observed in all age groups (2-5, 6-10, and 2-10), and increases in Obese were observed in 6-10-year olds. Most shifts occurred from healthy-weight individuals increasing in BMI category. Conclusions: We observed a significant increase in the proportion of children with overweight and obesity in a nationally representative MHS cohort from 2009 to 2016. The prevalence of obesity, but not overweight, in our cohort mirrored the civilian population. Increasingly heavier MHS and civilian children have implications for our future military force, as they are ineligible for military service if unable to meet weight standards.
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Affiliation(s)
- Dimas C. Espinola
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, MD, USA.,Department of Pediatrics, Pediatric Subspecialty Clinic, Brooke Army Medical Center, Houston, TX, USA
| | - Cara Olsen
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - Amanda Banaag
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, MD, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.,Address correspondence to: Amanda Banaag, MPH, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Tracey Pérez Koehlmoos
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, MD, USA
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Imoisili O, Dooyema C, Kompaniyets L, Lundeen EA, Park S, Goodman AB, Blanck HM. Prevalence of Overweight and Obesity Among Children Enrolled in Head Start, 2012-2018. Am J Health Promot 2021; 35:334-343. [PMID: 32996321 PMCID: PMC10864127 DOI: 10.1177/0890117120958546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Determine prevalence of overweight and obesity as reported in Head Start Program Information Reports. DESIGN Serial cross-sectional census reports from 2012-2018. SETTING Head Start programs countrywide, aggregated from program level to state and national level. SUBJECTS Population of children enrolled in Head Start with reported weight status data. MEASURES Prevalence of overweight (body mass index [BMI] ≥85th percentile to <95th percentile) and obesity (BMI ≥95th percentile). ANALYSIS Used descriptive statistics to present the prevalence of overweight and obesity by state. Performed unadjusted regression analysis to examine annual trends or average annual changes in prevalence. RESULTS In 2018, the prevalence of overweight was 13.7% (range: 8.9% in Alabama to 20.4% in Alaska). The prevalence of obesity was 16.6% (range: 12.5% in South Carolina to 27.1% in Alaska). In the unadjusted regression model, 34 states and the District of Columbia did not have a linear trend significantly different from zero. There was a statistically significant positive trend in obesity prevalence for 13 states and a negative trend for 3 states. CONCLUSION The prevalence of obesity and overweight in Head Start children remained stable but continues to be high. Head Start reports may be an additional source of surveillance data to understand obesity prevalence in low-income young children.
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Affiliation(s)
- Omoye Imoisili
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, GA, USA
- United States Public Health Service, Rockville, MD, USA
| | - Carrie Dooyema
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth A. Lundeen
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- United States Public Health Service, Rockville, MD, USA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Obesity Prevention and Control Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- United States Public Health Service, Rockville, MD, USA
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Pona AA, Carlson JA, Shook RP, Dreyer Gillette ML, Davis AM. Maternal BMI Change Linked to Child Activity Change in Family-Based Behavioral Interventions for Pediatric Weight Management. Child Obes 2019; 15:371-378. [PMID: 31184926 PMCID: PMC6691679 DOI: 10.1089/chi.2018.0284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background: This study investigated whether change in maternal BMI was associated with change in child's moderate-to-vigorous physical activity (MVPA) and prolonged sedentary time during the course of family-based behavioral interventions (FBBIs) for pediatric weight management. Methods: Children (n = 120) ages 5-12 [mean age = 9.04 ± 1.7) years with a baseline BMI ≥85th percentile (mean BMIz = 1.8 ± 0.5) and families were enrolled in one of three similar FBBIs for pediatric weight management and followed over 6-12 months. Activity data were collected through accelerometers. Mixed effects regression models assessed the relationship of maternal change in BMI to child change in (1) minutes/d of MVPA and (2) proportion of time spent in sedentary bouts lasting ≥10 minutes (termed prolonged sedentary time), and whether the effect of maternal BMI change was moderated by child age, sex, and race/ethnicity. Results: A decrease in maternal BMI was associated with both an increase in child MVPA, B = -2.77, t = -2.03, p = 0.048, and a decrease in proportion/d of prolonged sedentary time, B = 0.02, t = 2.40, p = 0.020, from baseline to follow-up. Child age moderated the association between maternal BMI change and change in child prolonged sedentary time (p = 0.095), whereby the association was limited to 5- to 10-year-olds and became stronger as age decreased. Conclusions: Improvement in maternal BMI showed important positive associations with child MVPA and prolonged sedentary time over the course of FBBIs for pediatric weight management. Targeting parent weight loss could improve child outcomes in FBBIs, particularly in younger children.
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Affiliation(s)
- Ashleigh A. Pona
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jordan A. Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
- Weight Management Program, Children's Mercy Hospital, Kansas City, MO
| | - Robin P. Shook
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
- Weight Management Program, Children's Mercy Hospital, Kansas City, MO
| | - Meredith L. Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
- Weight Management Program, Children's Mercy Hospital, Kansas City, MO
| | - Ann M. Davis
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
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Baran J, Weres A, Czenczek-Lewandowska E, Leszczak J, Kalandyk-Osinko K, Mazur A. Relationship between Children's Birth Weight and Birth Length and a Risk of Overweight and Obesity in 4-15-Year-Old Children. ACTA ACUST UNITED AC 2019; 55:E487. [PMID: 31443282 DOI: 10.3390/medicina55080487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 12/31/2022]
Abstract
Background and Objectives. The purpose of the study was to investigate the relationship between children’s birth weight/length and a risk of overweight and obesity. Materials and Methods. The study involved 747 children from kindergartens, as well as primary and middle schools from southeastern Poland. All the subjects were examined on fasting status. Each child was examined for body mass and height, in order to calculate their body mass index (BMI), and BMI centile. The parents completed a questionnaire related to basic information about the child and the family. Results. In the study group, the male infants presented greater birth body weight and birth body length. A comparison of the distribution of birth weights and lengths between the children with normal BMI and with high BMI showed statistically significant differences only in the case of birth length of 12–15-year-old children and in the group of boys aged 12–15 years. In the case of the female children and the group of 7–11-year-olds a statistically significant difference was found in the BMI centile at a later age—a higher centile was found in the girls and in the children aged 7–11 years classified as adequate for gestational age (AGA). Conclusions. Birth body weight is positively related to BMI centile; however, no significant differences were found in birth weight between children with overweight/obesity and children with normal body weight. Birth length is associated with a lower BMI centile only in boys aged 12–15 years, and lower birth length is found in boys with overweight and obesity.
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Goetz AR, Beebe DW, Peugh JL, Mara CA, Lanphear BP, Braun JM, Yolton K, Stark LJ. Longer sleep duration during infancy and toddlerhood predicts weight normalization among high birth weight infants. Sleep 2019; 42:5167948. [PMID: 30412240 PMCID: PMC6369726 DOI: 10.1093/sleep/zsy214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/18/2018] [Indexed: 11/13/2022] Open
Abstract
Study Objectives High birth weight (HBW; ≥ 4000 g) is strongly associated with later overweight, yet little is known about how to disrupt this trajectory. The current study examined sleep practices during infancy and toddlerhood among children born HBW or normal birth weight (NBW; 2500-3999 g). Methods Latent growth curve models were used to examine sleep during infancy and toddlerhood among 270 mother-child dyads enrolled in the Health Outcomes and Measures of the Environment Study. Total sleep duration in 24 hr, sleep maintenance, and restlessness/vocalizations were collected at 6 month intervals between ages 6 and 24 months. Height and weight were obtained at ages 24 or 36 months, and normal and overweight BMI were derived. Sleep was examined among children with a normal BMI during the preschool years who were either HBW (HBW-Normal, n = 36) or NBW (NBW-Normal, n = 184) compared with overweight preschoolers (Overweight, n = 50). It was predicted that the Overweight group would have poorer sleep across infancy and toddlerhood compared with HBW-Normal and NBW-Normal. Results HBW-Normal had the longest and Overweight had the shortest mean 24 hr sleep duration across all time points with NBW-Normal falling in-between the two groups. Compared with Overweight, HBW-Normal exhibited longer 24 hr sleep duration at age 6 months with this group difference maintained over infancy and toddlerhood. No group difference was found for NBW-Normal. Conclusions A longer sleep duration in the first several years of life is associated with development of normal BMI among HBW children. These findings suggest that longer sleep duration may protect HBW children from becoming overweight.
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Affiliation(s)
- Amy R Goetz
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - James L Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Bruce P Lanphear
- Child and Family Research Institute, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Kimberly Yolton
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
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Morais A, Kelly J, Bost JE, Vaidya SS. Characteristics of Correctly Identified Pediatric Obesity and Overweight Status and Management in an Academic General Pediatric Clinic. Clin Pediatr (Phila) 2018. [PMID: 29514514 DOI: 10.1177/0009922818761891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study identified and characterized the rates of documentation and guideline-based management of overweight and obese children within an academic pediatric clinic through a retrospective electronic medical record review of 7422 well-child visits in 2016. Diagnosis and treatment were analyzed by patient's weight diagnosis, sex, age, and provider training level. The percentages of correctly identified severely obese (90.2%), obese (77.0%), and overweight (42.0%) children were much higher than in previous retrospective chart reviews; however, less than 30% of children were referred for more intensive weight management to a dietitian or pediatric obesity weight management program. Increased provider training level was associated with a lower adherence to pediatric obesity guidelines. Strategic modifications to electronic medical records that automatically offer body mass index-associated weight diagnoses with a link to treatment pathways and resources are needed to facilitate improved compliance with current pediatric obesity guidelines in the primary care setting.
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Affiliation(s)
- Ana Morais
- 1 George Washington University, Washington, DC, USA
| | - Joseph Kelly
- 2 Children's National Health System, Washington, DC, USA
| | - James E Bost
- 2 Children's National Health System, Washington, DC, USA
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Berlin KS, Kamody RC, Thurston IB, Banks GG, Rybak TM, Ferry RJ. Physical Activity, Sedentary Behaviors, and Nutritional Risk Profiles and Relations to Body Mass Index, Obesity, and Overweight in Eighth Grade. Behav Med 2017; 43:31-39. [PMID: 25909358 DOI: 10.1080/08964289.2015.1039956] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this article was to determine (1) the existence of individually varying patterns of physical activity, sedentary behavior, and nutrition intake risk; and (2) how these risk-patterns relate to youth's demographics, Body mass index (BMI) and psychosocial functioning. Participants (N = 9,304) from the 2007 8th Grade Early Childhood Longitudinal Study Cohort completed the revised Self-Description Questionnaire II. Age, sex, height, and weight were used to calculate body mass index (BMI) z scores and percentiles. Three risk profiles emerged via Latent Profile Analyses: "Active + Healthy Diet" (AHD; 16.3% Obese); "Sedentary + Unbalanced Diet" (SUD; 21.3% Obese); and "Screen-Time + Recreational Food" (STRF; 25.0% Obese). Significant differences in BMIs, psychosocial factors, and demographic characteristics were found across the profiles. Differential patterns of physical activity, sedentary behavior, and nutritional choices were found to predict BMI and psychosocial functioning. These findings may be helpful to refine and develop modular-based prevention and weight control intervention programs.
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Affiliation(s)
- Kristoffer S Berlin
- a The University of Memphis and University of Tennessee Health Science Center
| | | | - Idia B Thurston
- a The University of Memphis and University of Tennessee Health Science Center
| | | | | | - Robert J Ferry
- a The University of Memphis and University of Tennessee Health Science Center
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Abstract
PURPOSE To determine if a guideline-based electronic health record (EHR) template and staff education would increase diagnosis and treatment of overweight and obese children. METHOD At a large pediatric office, a minitemplate was customized to pediatric obesity evidence-based practice guidelines. Staff were educated regarding current guidelines and instructed to merge minitemplate to EHR encounters in which body mass indexes (BMIs) were greater than the 85th percentile, thus integrating assessment questions, overweight or obese diagnoses, and triggered treatment order sets. RESULTS A total of 9701 charts of 2- to 18-year-old patients presenting over 6 months were reviewed. Preintervention, 52% with BMIs greater than the 85th percentile had diagnoses of overweight or obese in problem lists; 86% received treatment when diagnosed. Postintervention, 75% had diagnoses in problem lists, and 96% received treatment. CONCLUSION This initiative illustrated how EHR customization and staff education improved the diagnosis and treatment of pediatric overweight and obesity.
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Abstract
The purpose of the Pediatric Overweight Quality Improvement Initiative (POWQII) was to demonstrate the feasibility and value of simple interventions for improving pediatric care and to address the additional needs of overweight and obese children. Practices were recruited from around New Mexico, with 16 pediatricians completing the POWQII within 9 to 12 months. Initially, documentation of BMI percentile across all practices was only 49%, increasing to more than 90% on average following the first intervention and eventually reaching an average of 99%. Nutrition and physical activity counseling started at 52% and 39%, respectively, increasing to 87% for nutrition and 77% for physical activity. Diagnosis of POW patients improved over the course of the POWQII (67% to 94%). This intervention's potential impact can extend to a larger population of patients, resulting in twice as many receiving screening for POW and increasing best practices known to improve ongoing care and patient outcomes.
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Affiliation(s)
- Kasey L Brandt
- Envision New Mexico, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87111, USA.
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Wojcicki JM, Schwartz N, Jiménez-Cruz A, Bacardi-Gascon M, Heyman MB. Acculturation, dietary practices and risk for childhood obesity in an ethnically heterogeneous population of Latino school children in the San Francisco bay area. J Immigr Minor Health 2012; 14:533-9. [PMID: 22101726 PMCID: PMC4456089 DOI: 10.1007/s10903-011-9553-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Previous studies have found increased acculturation to the US lifestyle increases risk for obesity in Latinos. However, methodologies differ, and results in children are inconsistent. Moreover, previous studies have not evaluated risk factors within the heterogeneous US population. We recruited 144 self-identified Latino school children and their mother or father in grades 4-6 in San Francisco parochial schools and South San Francisco public schools using an information letter distributed to all students. Children and parents had weights, heights, demographic information, dietary patterns and lifestyle variables collected in English or Spanish through an interview format. A high percentage of our children were overweight [≥85th percentile body mass index (BMI)] (62.5%) and obese (≥95th percentile BMI) (45.2%). Correspondingly parents also had a high percentage of overweight (BMI ≥ 25 & <30) (40.8%) and obesity (BMI ≥ 30) (45.3%). Mexico was the country of origin for 62.2% of parents, and 26.6% were from Central or South America. In multivariate logistic analysis, speaking Spanish at home was an independent risk factor for obesity [odds ratio (OR) 2.97, 95% confidence interval (CI) 1.28-6.86]. Eating breakfast daily (OR 0.34, 95% CI 0.15-0.78) and consumption of tortas (a Mexican fast food sandwich) (OR 0.45, 95% CI 0.21-1.00) were associated with decreased risk. In stratified analysis, significant differences in risk factors existed between Mexican origin versus Central/South American Latino children. The processes of acculturation likely impact eating and lifestyle practices differentially among Latino groups. Interventions should focus on ensuring that all children eat a nutritious breakfast and take into consideration ethnicity when working with Latino populations.
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Affiliation(s)
- Janet M Wojcicki
- Department of Pediatrics, University of California, San Francisco, CA 94143-0136, USA.
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