New Chicago program to improve care for overweight children
April 13, 2009 - The Illinois Chapter of the American Academy of Pediatrics (ICAAP) and Children’s Memorial Hospital have joined forces on a two-year project to improve pediatric practices’ ability to manage overweight children both within the practice through screening, counseling and appropriate clinical services, as well as outside the practice through successful referrals to community resources.
During the past 30 years, the prevalence of overweight and obesity among children and youth in the U.S. has increased dramatically. Chronic illness such as obesity and Type 2 diabetes are at epidemic proportion, and increasingly diagnosed in pediatric patients. The cumulative evidence is that much of the illness and death associated with these conditions may be preventable through dietary and lifestyle modifications. However, behavior modification is difficult to accomplish and requires patients and their families to recognize the problem and be motivated to change.
The two-year project entitled Promoting Health: Strengthening Practices and Links to Community Resources, funded by a grant from the Otho S.A. Sprague Memorial Institute, will investigate effective ways to help pediatric practices facilitate positive change in the health of their overweight patients. During the first year of the project, the partners will pilot the project at three pediatric practices in Chicago.
These sites will:
- Receive training on clinical topics and patient management strategies, including counseling, nutrition, behavioral influences and weight-related health problems.
- Identify a practice staff member to serve as a community coordinator to work with patients and their families to access community resources.
- Initiate quality improvement processes with the support and ongoing facilitation of ICAAP.
Children's Memorial will evaluate the effectiveness of the program at these pilot sites, assessing multiple factors such as changes in care delivery, the practice’s ability to connect families with resources, and patient/family success in using the services provided by those community resources. Children's Memorial will compare results at the pilot practices with results at control practices, which will receive only printed materials and limited feedback and technical assistance. Evaluations will also assess barriers to participation in community programs from family and community perspectives.
In year two, the organizations hope to involve pediatricians from approximately 20 additional practices to receive the educational portion of the program. Project leaders will use the feedback of the doctors, nurses, and families at these practices to refine the training and referral systems so the program can eventually be replicated by practices throughout the region. If successful, the program will benefit the families as well as the health care providers and the community agencies who serve them.
“Obesity is an alarming threat to the health of children in America,” said Mary Elsner, ICAAP Project Director. “This program provides ICAAP and Children's Memorial an important opportunity to evaluate ways to maximize existing resources within pediatric practices and community programs. By improving awareness and screening, helping practices better handle weight issues internally, and helping them to connect patients to additional resources already existing in the community, we can begin to change the quality of care for overweight children.”
The Promoting Health project is designed to address needs identified in medical literature and through a survey of Illinois pediatricians. The survey of Illinois pediatricians conducted by ICAAP and Children's Memorial looked at current obesity care routines, existing community resources and outstanding needs regarding the management of health issues related to overweight children. Results identified a need to improve skills at the practice level, particularly in screening and nutrition education. Specifically:
- Not all pediatricians engage in regular obesity screening. Most pediatricians (70 percent) reported they always obtain body mass index (BMI) for children age 2 and over, but only 46 percent indicated compliance with recommended obesity-related screening practices.
- Pediatricians are more likely to engage in screening practices when there is a structured weight management program/protocol available locally.
- Structured programs/protocols for management of overweight children were locally available to 62 percent of respondents, and 52 percent had a locally available multidisciplinary weight management program.
While the survey showed that in most cases there are existing programs available locally, there is a need for assistance in connecting patients and their families to these programs. A 2008 study published in Pediatrics suggested that low-income parents may have negative perceptions of community resources, noting that parents often felt overwhelmed when trying to access resources or felt the individuals staffing community agencies were judgmental or intrusive. The Promoting Health project will assess whether medical practices can help facilitate connections with community organizations and reduce barriers to successful engagement.
“The medical home or patient-centered care model calls for primary care to coordinate care across all elements of the health care system and the patient’s community,” said Scott Allen, ICAAP executive director. “The Promoting Health project will create stronger medical homes for families by helping practices coordinate care with community resources that address physical activity and nutrition.”
About ICAAP
ICAAP is an organization of 2,300 pediatricians that conducts advocacy and provides continuing medical education for child health care providers. The ICAAP mission is to promote the right of all children to live happy, safe and healthy lives; to ensure children receive quality medical care from pediatricians (the most qualified physicians to deliver this care); and to assess and serve the needs of its membership.
For more information, contact, Mary Elsner, ICAAP Project Director, at 312.733.1026 Ext. 220 or Jana Estell, ICAAP Media Coordinator, at 312.733.1026 Ext. 209.
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