5-4-3-2-1 Go! Coordinating Pediatric Resident Education and Community Health Promotion to Address the Obesity Epidemic in Children and Youth

Abstract

This study investigated the feasibility and effectiveness of training pediatric residents to conduct a brief clinic-based behavioral intervention in coordination with community dissemination of a health promotion message developed by the Consortium for Lowering Obesity in Chicago Children. A total of 113 residents completed a short (<60 minutes) online training program. Some (64) residents distributed interview contact cards to patients they saw in their continuity of care clinics after training; others (45) distributed cards before training. A researcher interviewed 75% of the 509 patients 4 weeks after the visit. More patients of trained residents reported positive changes in behaviors which have been associated with lower obesity rates: increased intake of fruits and vegetables (28% vs 16%, P < .01), increased intake of water (30% vs 19%, P < .01), increased physical activity (40% vs 29%, P < .03), and decreased television time (36% vs 24%, P < .01). Brief training using the 5-4-3-2-1-Go! message seems to be feasible and effective.

Physicians and Physician Trainees Rarely Identify or Address Overweight/Obesity in Hospitalized Children

“…Education about obesity treatment for pediatric residents has been shown to improve patient outcomes in the outpatient setting. 20 We are not aware of a similar study in the inpatient setting.…”

Expanding the Role of Primary Care in the Prevention and Treatment of Childhood Obesity: A Review of Clinic- and Community-Based Recommendations and Interventions

“…Examples of individual case management include private, age-appropriate conversations with clinicians regarding achieving healthy weight; goal setting; motivational interviewing; and conversations with registered dieticians about patient readiness, diet, and exercise. Of the seven studies in this category, six measured positive results—including weight loss, improved lifestyle habits, or increased parent confidence using provider recommendations—after patients participated in multiple individual sessions with the providers [15, 40–45]. Successful studies emphasized the need for providers to engage the patient in a dialogue about lasting lifestyle changes and the benefits of training clinicians on how to address ambivalence about making behavioral changes.…”

“…Seven of the articles reviewed involved training for physicians, nurses, and/or registered dieticians on the use of motivational interviewing techniques, goal setting for parents and children, and/or evidence-based tools for facilitating discussions on obesity. In most cases, training took place in person in a group format, though Stahl et al [40] described a successful web-based training program for clinicians. Two studies described the results of provider education interventions.…”

“…Web-based or in-person primary care clinician trainings for assessment of BMI, healthful eating, and active living habits among children and adolescents were found to be effective in increasing provider confidence in weight assessment [31, 40], rates of BMI assessment, and use of behavioral screening tools after at least a year [32, 38]. Trainings included reference charts for BMI and laboratory values, guidelines for discussion about healthy behaviors, and decision support charts.…”

Fitwits

“…31 Busy office-based resident and community physicians expressly want time-efficient tools to communicate weight problems and patient management guidelines. 7,[31][32][33][34][35][36] Two brief office tools, designed for physician-parent discussion about younger children, were recently assessed in practice settings. 7,[31][32][33][34][35][36] Two brief office tools, designed for physician-parent discussion about younger children, were recently assessed in practice settings.…”