Improving providers' assessment and management of childhood overweight: results of an intervention.

OBJECTIVE: Pediatric primary care providers' adherence to recommendations for the assessment and management of childhood overweight is low. There are scarce data addressing how to improve provider practices. This study evaluated the effect of provider training and office-based tool dissemination on...

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Publicado en:Ambulatory Pediatrics Vol. 7; no. 6; pp. 453 - 458
Autores principales: Dunlop AL, Leroy Z, Trowbridge DL, Kibbe DL
Formato: research Journal Article
Publicado: Elsevier B.V. Nov/Dec2007
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov/Dec2007
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      pub: Elsevier B.V.
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        10.1016/j.ambp.2007.07.006
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        atl: Improving providers' assessment and management of childhood overweight: results of an intervention.
      aug:
        au:
          Dunlop AL
          Leroy Z
          Trowbridge DL
          Kibbe DL
        affil: Emory University School of Medicine, Department of Family & Preventive Medicine, 735 Gatewood Rd NE, Atlanta, Georgia 30322
      sug:
        subj:
          Health Promotion
          Obesity Therapy
          Practice Patterns
          Body Mass Index
          Child
          Counseling
          Diet
          Female
          Male
          Medical Records
          Obesity Diagnosis
          Practice Guidelines
          Primary Health Care
          Human
          Child: 6-12 years
          Female
          Male
      ab: OBJECTIVE: Pediatric primary care providers' adherence to recommendations for the assessment and management of childhood overweight is low. There are scarce data addressing how to improve provider practices. This study evaluated the effect of provider training and office-based tool dissemination on pediatric providers' assessment and management of childhood overweight. METHODS: Provider practices before and after training and office-based tool dissemination were compared. Participants were resident and faculty providers at 6 urban, community-based primary care clinics affiliated with an academic medical center. Three months after completion of two 1-hour training sessions, clinic sites were provided with tools in bulk, and office staff were coached to distribute the tools during patient encounters. Provider practices were ascertained by medical record abstraction at baseline and at 3 and 6 months. The proportion of medical records with documentation of recommended practices, including recording of body mass index percentile (BMI%), obtaining a nutrition-activity history, and providing nutrition-activity counseling, was compared with chi(2) tests and logistic regression. RESULTS: During the initial 3 months after training, provider documentation of recommended practices did not significantly improve compared with baseline. During the subsequent 3 months, after office-based distribution of tools, provider documentation of recommended practices improved significantly compared with baseline (28.8% vs 11.6% for BMI% [P < .001], 80.2% vs 49.8% for nutrition-activity history [P < .001], and 47.7% vs 33.3% for nutrition-activity counseling [P < .001]). CONCLUSIONS: Pediatric providers' adherence to recommendations for the assessment and management of childhood overweight may improve with provider training linked to the office-based distribution of tools to promote performance of recommendations.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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