Childhood Obesity, Overweight
Conditions
Keywords
childhood obesity, childhood overweight, primary care, weight management
Brief summary
The purpose of this study is to identify whether specific clinical practices-including attention to body-mass-index (BMI) screening/overweight/obesity, medical risk (from conditions associated with overweight/obesity such as high blood pressure), and following up to reassess progress-will improve the weight status of overweight school-age children.
Detailed description
The aim of this study is to identify specific clinical practice elements in pediatric primary care that predict improvement in weight status among overweight school-age children. Pediatricians are well-suited to regularly assess and treat school-age children who are overweight. Well-child visits present an important opportunity to assess and treat overweight children. Strategies are needed to maximize the effectiveness of this opportunity. Although the American Academy of Pediatrics endorses recommendations by the United States Preventive Services Task Force that clinicians screen for overweight, assess medical/behavior risk, and use a staged treatment approach that includes frequent reassessment, it is unclear whether these practices, when used in primary care, impact whether children make lifestyle changes or improve their weight status. It is essential to identify specific clinical practice elements and communication strategies associated with weight-status improvement in overweight children, to maximize the effectiveness of primary-care weight-management interventions. The investigators hypothesize that, during primary-care visits with overweight 6-12-year-old children, attention to high BMI, medical risk (from weight-related comorbidities such as high blood pressure), and reassessing progress (defined as having a primary-care visit with evidence of attention to BMI or completing a referral to a weight-management specialist or nutritionist) will be associated with improvement in weight status (assessed as decrease in percent overweight (percentage above the age/sex-specific 95th BMI percentile) at follow-up.
Interventions
OTHERAttention to BMI
Evidence (using electronic health record data) denoting provider attention to about high BMI.
OTHERAttention to high-BMI-related Medical Risk
Evidence (using electronic health record data) denoting provider attention to high-BMI-related medical risk, including from high blood pressure/hypertension, cholesterol/dyslipidemia, blood sugar/diabetes, liver enzymes/fatty liver, and low vitamin D/vitamin-D deficiency.
OTHERNo attention to high BMI or high-BMI-related medical risk
Lack of evidence (using electronic health record data) denoting provider attention to high BMI or high-BMI-related medical risk.
Sponsors
National Heart, Lung, and Blood Institute (NHLBI)
University of Texas Southwestern Medical Center
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* 6-12 year-old children with ≥2 visits * valid height and weight data at each visit * BMI ≥85th percentile at the first visit
Exclusion criteria
* children \<6 and \>12 years old * no valid height and weight data at two visits * BMI \<85th percentile at all 6-12 year-old well child visits
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| weight-status improvement | From one visit to the next and from one well-child visit to the next | Children with a decrease in BMI percent relative to the age/sex-specific BMI at the 95th percentile |
Countries
United States
Outcome results
None listed