Factors Associated with Attendance after Referral to a Pediatric Weight Management Program

Shaffer, Laura A.; Brothers, Kyle B.; Burkhead, Thomas A; Yeager, Ray; Myers, John; Sweeney, Brooke

doi:10.1016/j.jpeds.2016.02.011

Cited by 29 publications

(28 citation statements)

References 14 publications

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“…In a child weight management program in a multispecialty health care practice, 41% of patients referred to a weight management program attended an initial presentation ( 9 ). A few studies ( 10 , 11 ) compared rates of enrollment relative to potentially eligible patients, not only those who were physician-referred. One study of adolescents evaluated several strategies to refer patients, one of which bypassed the medical provider by sending letters to patients deemed qualifying from electronic health record (EHR) data; that study found that approximately 9% of patients with obesity enrolled ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices

et al. 2017

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Purpose and ObjectivesPrimary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to a trial of weight management programs. This article describes recruitment strategies developed to benefit both families and health care practices and the modification of electronic health records (EHRs) to reflect recruitment outcomes.Intervention ApproachTo facilitate family participation, materials and programs were provided in English and Spanish, and programs were conducted in convenient locations. To support health care practices, EHRs and print materials were provided to facilitate obesity recognition, screening, and study referral. We provided brief training for providers and their office staffs that covered screening patients for obesity, empathetic communication, obesity billing coding, and use of counseling materials.Evaluation MethodsWe collected EHR data from 2012 through 2014, including demographics, weight, and height, for all patients aged 2 to 12 years who were seen in the 12 provider practices during the study’s recruitment phase. The data of patients with a body mass index (BMI) at or above the 85th percentile were compared with the same data for patients who were referred to the study and patients who enrolled in the study. We also examined reasons that patients referred to the study declined to participate.ResultsOverall, 26% of 7,845 patients with a BMI at or above the 85th percentile were referred to the study, and 27% of referred patients enrolled. Enrollment among patients with a BMI at or above the 85th percentile was associated with being Hispanic and with more severe obesity than with patients of other races/ethnicities or less severe obesity, respectively. Among families of children aged 2 to 5 years who were referred, 20% enrolled, compared with 30% of families of older children (>5 y to 12 y). Referral rates varied widely among the 12 primary care practices, and referral rates were not associated with EHR modifications.Implications for Public HealthEngagement and recruitment strategies for enrolling families in primary care practice in weight management programs should be strengthened. Further study of factors associated with referral and enrollment, better systems for EHR tools, and data on provider and office adherence to study protocols should be examined. EHRs can track referral and enrollment to capture outcomes of recruitment efforts.

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Section: Introductionmentioning

confidence: 99%

Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices

et al. 2017

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“…A Pearson correlation test examined the relationship between potential covariates (child age, child gender, SCD genotype, family income, and caregiver education) and percent nonattendance. These potential covariates were determined based off previous literature in pediatric clinic attendance (Paterson et al, 2010;Cronin, et al, 2018;Shaffer et al, 2016;Schlenz et al, 2016).…”

Section: Statistical Analysesmentioning

confidence: 99%

Examining Caregiver Coping and Clinic Attendance in Pediatric Sickle Cell Disease

Evans

2020

UFJUR

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Sickle Cell Disease (SCD), the most common genetic disorder in the U.S., primarily affects youth of African or Latino backgrounds. Regular clinic attendance promotes positive health outcomes in pediatric SCD. Caregivers of youth with SCD endorse high levels of stress that may disrupt clinic attendance. Improved caregiver coping may help address barriers to clinic attendance in SCD families. Sixty-three caregivers and youth (Mage = 13.2, 60.3% male) completed the Responses to Stress Questionnaire- Sickle Cell Disease (RSQ-SC). The RSQ-SC assesses primary control engagement (PCE), secondary control engagement (SCE), and disengagement coping. The researchers tabulated percent of pediatric hematology appointments attended, canceled by patient/provider/due to hospitalization, and no-showed over the past year via medical chart review. Results indicated a significant positive association between caregiver education and percentage of appointments attended (r = .295, p = 0.19). A hierarchical regression revealed that caregiver coping did not predict clinic attendance [F (4, 58) = 2.114, p = 0.091, R2 Δ = 0.040] when controlling for caregiver education. In isolation, caregiver coping may not be an effective target for interventions focused on improving adherence to pediatric hematology appointments.

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“…Enrolment in obesity interventions varies depending on children's age, sex and weight status as well as parents' income, education and perceptions of their children's lifestyle behaviours . Older children and children with obesity are more likely to be (i) seen by their parents as having a weight problem and (ii) referred to and enroled in obesity interventions compared with their younger and leaner peers . However, children who are younger and less overweight are more likely to benefit from care .…”

Section: The Enrolment Paradox: Those Who Are More Likely To Enrol Armentioning

confidence: 99%

“…isolation) consequences . Engagement in pediatric weight management, broadly defined as broadly defined as treatment‐related decisions and actions that may or may not benefit patients, is characterized by low enrolment, high attrition and poor adherence . It is our view that three paradoxes related to engagement might help to explain why many children and families fail to achieve optimal outcomes in pediatric weight management.…”

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confidence: 99%

Paradoxically speaking about engagement in pediatric weight management

Perez

Ball

2017

Pediatric Obesity

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Factors Associated with Attendance after Referral to a Pediatric Weight Management Program

Cited by 29 publications

References 14 publications

Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices

Strategies to Recruit a Diverse Low-Income Population to Child Weight Management Programs From Primary Care Practices

Examining Caregiver Coping and Clinic Attendance in Pediatric Sickle Cell Disease

Paradoxically speaking about engagement in pediatric weight management

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