Improving Hispanic childhood obesity using an algorithm-based quality initiative in pediatric primary care

Abstract

Child obesity is increasing and is considered one of the most serious health concerns of the 21st century. Hispanic children represent the largest group of obese children in the U.S. when compared to other ethnic groups. Health care providers (HCPs) have been recognized as key players in the prevention and treatment of child obesity, yet many studies indicate clinical practice guidelines are not always followed. The purpose of this quality initiative was to improve HCP management, and counseling of overweight and obese Hispanic children between the ages of 6-16 years, by providing an educational session and management tools to pediatric providers in a South Texas clinic. HCPs attended a 30-minute educational session, guided by the American Academy of Pediatrics’ algorithm for childhood obesity management; and the 5210 Healthy Habits Questionnaire was used to assist providers with assessment and counseling of patients and parents. Provider practice changes were compared to the same timeframe a year earlier via chart review. The sample of charts reviewed included 193 children, 51% male, 41% overweight or obese in 2019 and 135 children, 41% male, 47% overweight or obese in 2020; at least 96% identified as Latino/Hispanic and mean age was 10.4 years in both groups. Provider documentation of healthy activities assessment improved 17-25%, healthy habit counseling 12- 21.5%, and referrals to dietitian 6%, post-intervention. Results were promising and trending toward positive practice changes, however greater improvement in HCP practices and patient outcomes may have been realized if the timeline of the project had not been interrupted by competing healthcare priorities due to the COVID-19 pandemic. Providing algorithm-based education and resources for primary care providers in a pediatric clinic can improve practice and has the potential to impact outcomes for overweight and obese Hispanic children.