Perspectives on Obesity Programs at Children's Hospitals: Insights From Senior Program Administrators

Eneli, Ihuoma; Norwood, Victoria F.; Hampl, Sarah; Ferris, Michelle; Hibbeln, Trillium; Patterson, Kellee; Pomietto, Maureen; Hassink, Sandra G.

doi:10.1542/peds.2011-0480i

Cited by 19 publications

(15 citation statements)

References 13 publications

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“…Multidisciplinary approaches in diverse sectors, including pediatric primary care, have been proposed to reduce the high prevalence of childhood obesity [4]. …”

Section: Introductionmentioning

confidence: 99%

2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

Cheng

Wen

Coletti

et al. 2014

International Journal of Pediatrics

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Objective. To examine body mass index (BMI) changes among pediatric multidisciplinary weight management participants and nonparticipants. Design. In this retrospective database analysis, we used multivariable mixed effect models to compare 2-year BMI z-score trajectories among 583 eligible overweight or obese children referred to the One Step Ahead program at the Boston Children's Primary Care Center between 2003 and 2009. Results. Of the referred children, 338 (58%) attended the program; 245 (42%) did not participate and were instead followed by their primary care providers within the group practice. The mean BMI z-score of program participants decreased modestly over a 2-year period and was lower than that of nonparticipants. The group-level difference in the rate of change in BMI z-score between participants and nonparticipants was statistically significant for 0–6 months (P = 0.001) and 19–24 months (P = 0.008); it was marginally significant for 13–18 months (P = 0.051) after referral. Younger participants (<5 years) had better outcomes across all time periods examined. Conclusion. Children attending a multidisciplinary program experienced greater BMI z-score reductions compared with usual primary care in a real world practice; younger participants had significantly better outcomes. Future research should consider early intervention and cost-effectiveness analyses.

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“…Multidisciplinary approaches in diverse sectors, including pediatric primary care, have been proposed to reduce the high prevalence of childhood obesity [4]. …”

Section: Introductionmentioning

confidence: 99%

2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

Cheng

Wen

Coletti

et al. 2014

International Journal of Pediatrics

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“…12,13 Advocacy organizations such as the Children' s Hospital Association also have supported pediatric quality improvement projects executed by its members throughout the United States. [14][15][16] Over the last several years, children' s hospitals in selected states have begun to recognize the value of collaboration at a statewide level. 17,18 The partnerships that form within states have the advantages of proximity for meeting opportunities and shared state regulations for data transparency.…”

Section: Discussionmentioning

confidence: 99%

A Statewide Collaborative to Reduce Pediatric Surgical Site Infections

et al. 2014

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BACKGROUND: Surgical site infections (SSIs) are preventable events associated with significant morbidity and cost. Few interventions have been tested to reduce SSIs in children.METHODS: A quality improvement collaboration was established in Ohio composed of all referral children' s hospitals. Collaborative leaders developed an SSI reduction bundle for selected cardiac, orthopedic, and neurologic operations. The bundle was composed of 3 elements: prohibition of razors for skin preparation, chlorhexidinealcohol use for incisional site preparation, and correct timing of prophylactic antibiotic administration. The incidence of SSIs across the collaborative was compared before and after institution of the bundle. The association between 1 of the bundle elements, namely correct timing of antibiotic prophylaxis, and the proportion of centers achieving 0 SSIs per month was measured.RESULTS: Eight pediatric hospitals participated. The proportion of months in which 0 SSIs per center was recorded was 56.9% before introduction of the bundle, versus 81.8% during the intervention (P , .001). Correct timing of preoperative prophylactic antibiotics also significantly improved; 39.4% of centers recorded correct timing in every eligible surgical procedure per month ("perfect timing") before the intervention versus 78.7% after (P , .001). The achievement of 0 SSIs per center in a given month was associated with the achievement of perfect antibiotic timing for that month (P , .003). CONCLUSIONS:

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“…While RDs have been proven effective for treating patients with a variety of medical nutrition conditions, they are rarely integrated into primary care teams [88]. In addition, low reimbursement of obesity interventions and high overhead costs are of concern to hospitals administrators [89, 90]. Lee et al (2010) [91] showed that Medicaid in ten states addressed childhood nutritional and behavioral therapy reimbursement and billing codes for obesity, Medicaid in ten states did not address it, and Medicaid in the remaining 30 states had unclear guidelines.…”

Section: Review Processmentioning

confidence: 99%

Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going?

et al. 2016

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Since the “2007 summary report of child and adolescent overweight and obesity treatment” published by Barlow, many obesity intervention studies have been conducted in pediatric ambulatory care. Although several meta-analyses have been published in the interim, many studies were excluded because of the focus and criteria of these meta-analyses. Therefore, the primary goal of this article was to identify randomized case-control trials conducted in the primary care setting and to report on treatment approaches, challenges, and successes. We have developed four themes for our discussion and provide a brief summary of our findings. Finally, we identified major gaps and potential solutions, and describe several urgent key action items.

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Perspectives on Obesity Programs at Children's Hospitals: Insights From Senior Program Administrators

Cited by 19 publications

References 13 publications

2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

A Statewide Collaborative to Reduce Pediatric Surgical Site Infections

Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going?

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