1. Allen Strickler Susan Cluett Paige Hornsby MPH Presentation 22 April 2011 ADDRESSING THE CURRENT PEDIATRIC OBESITY EPIDEMIC THROUGH HEALTH CARE PROVIDER EDUCATION

2. 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

3. INTRODUCTION Pediatrics overweight/obesity defined by BMI (kg/m 2 ): 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

4. SIGNIFICANT HEALTH ISSUE http://www.obesityhelp.com

5. 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.

6. 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

7. QUESTIONNAIRE RESULTS Completion rate: 70/310 (23%) Question categories: HCP characteristics, practices, CFC specific, open-ended Analyzed data in QuestionPro Cross tabulation

8. CHARACTERISTICS

9. PRACTICES

11. CFC SPECIFIC

13. OPEN-ENDED QUESTION RESPONSES

14. CROSS TABULATION

16. 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

17. 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

18. 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’

19. REFERENCES “Obesity in Children and Adolescents: Guidelines for Prevention and Management”, 2004, http://findarticles.com/p/articles/mi_qa3958/is_200408/ai_n9454138/. 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