Improving child obesity screening and management provider practices in a South Texas pediatric clinic
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Abstract
Childhood obesity is an epidemic in the United States (US) and affects nearly one in five school-aged children. Inconsistent provider practice patterns, which often do not adhere to current clinical practice guidelines, can decrease the quality of childhood obesity screening and management. This quality improvement (QI) project implemented a provider education, reminder, screening and referral program to improve screening and management of overweight and obese children, aged 6-12 years old, attending a South Texas pediatric clinic. A comparative two-group, retrospective chart review and descriptive survey design guided the project. Eleven parents were surveyed and 126 charts (from 3 providers) were reviewed (pre-education: n=71; post-education: n=55). Provider practice post-education and reminder system was significantly improved on the use of overweight and obesity diagnosis codes (χ2 (1, N = 126) = 12.77, p<.001), overweight and obese labs ordered by provider (χ2 (1, N=126) = 9.49, p=.002), overweight and obese healthy behavior counseling (χ2 (1, N=126) = 14.14, p<.001), and follow-up visit recommendation (χ2 (1N=126) = 15.88, p<.001). There was no significant difference between groups in provider referrals to a fitness program. The parental survey indicated a significant improvement in child activity and nutrition behaviors patterns pre-provider education compared to post-provider education (Z=-2.805, p=.005, r=.25). A provider education program improved the screening and management practices of providers for children with overweight and obesity in a small pediatric clinic in South Texas.