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Clin Pediatr (Phila) ; 58(5): 511-520, 2019 05.
Article in English | MEDLINE | ID: mdl-30841719

ABSTRACT

Overweight and obese children are at an increased risk of remaining obese. The American Academy of Pediatrics recommends addressing healthy habits at well-child checks, but this poses challenges, especially in low-income populations. A clinical innovation project was designed to adapt recommendations in a busy urban clinic and consisted of motivational interviewing, culturally tailored tools, and standardizing documentation. A quasi-experimental design examined innovation outcomes. Of 137 overweight and obese children aged 24 to 66 months, providers' documentation of weight during well-child check visits improved post-innovation ( P < .01), as did development of healthy habits goals ( P < .001). Families were more likely to return for visits post-innovation ( P = .01). A logistic regression analysis showed that adding body mass index to the problem list and establishing a specific follow-up timeframe most predicted follow-up visits to assess progress ( P < .001). Comprehensive innovations consisting of motivational interviewing, implementation of culturally tailored tools, and standardized documentation can enhance engagement in an urban clinic setting.


Subject(s)
Early Medical Intervention/methods , Health Promotion/methods , Pediatric Obesity/diagnosis , Pediatric Obesity/therapy , Pediatrics/methods , Primary Health Care/methods , Child , Child, Preschool , Culturally Competent Care , Female , Follow-Up Studies , Healthy Lifestyle , Humans , Logistic Models , Male , Motivational Interviewing , Pediatric Obesity/economics , Poverty , Urban Health , Vulnerable Populations
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