Improving access and systems of care for evidence‐based childhood obesity treatment: Conference key findings and next steps

Abstract

Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care.

Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States

“…For many children, excess body weight extends into adulthood and increases the risk of adverse health conditions and death, so weight control in childhood should be a major focus of any strategy to control the obesity epidemic . School‐based interventions can provide an opportunity for promoting healthy diet, physical activity, and weight control, as well as family‐based interventions .…”

“…Effective implementation of preventive measures (consultation, screening, and treatment) in the health care system and increasing awareness through education campaigns may help to reduce excess body weight and alcohol intake and promote healthier diet and physical activity . Some regulations may be highly beneficial, such as taxation and reducing marketing of nonessential high‐calorie foods, sugary beverages, and alcohol; regulating alcohol outlet density and the days and hours of alcohol sale; and improving civil structure (eg, increasing public transportation and safe sidewalks) .…”

Remission of obesity among a nationally representative sample of US children

“…Finally, in the ECLS‐K cohort, obesity remission likely occurred outside of clinical treatment, providing insight into the natural history of early childhood obesity in the USA. Given the low obesity diagnosis rates in ambulatory and well‐child visits – 0.78% and 0.93%, respectively – and the small percentage of hospitals in the USA that offer comprehensive weight management services , it is unlikely that many children in this cohort were engaged in clinical treatment for obesity.…”

High intensity versus low intensity family-based childhood obesity treatment programs: Effectiveness, engagement and implementation outcomes from a randomized controlled trial in medically underserved region

“…Re ective of the prevalence, disparities, and associated health consequences, childhood obesity is a national priority [1,5,6]. Unfortunately, access to evidencebased childhood obesity interventions in the US is a challenge, especially in medical underserved regions [7].…”