Bethesda, MD -- March 4, 2010 -- An article published earlier this week by Health Affairs discusses a new approach to managing child obesity that supports the delivery of so-called secondary care -- referral-based specialized visits -- by primary care teams within community health centers. Eight centers in Massachusetts have launched the Healthy Weight Clinic, and the results over fifteen months show significant changes in clients' physical activity, food consumption, and Body Mass Index (BMI).
Specialized Care Of Overweight Children In Community Health Centers
By Shikha G. Anand, William G. Adams, and Barry S. Zuckerman
Anand is an assistant professor of pediatrics at the Boston Medical Center and pediatric director at the Whittier Street Health Center in Roxbury, Mass., and Adams is an associate professor of pediatrics at the Boston University School of Medicine, where Zuckerman is a professor and chair of pediatrics.
Since child obesity is a growing epidemic in this country, particularly among African American, Latino, and lower socioeconomic groups, the Healthy Weight Clinic has shown success by tailoring its approach to the special needs of these groups. In addition to the primary care physician, patients meet with a dietician and a case manager, making six monthly or semi-monthly visits in all During the initial intake, team members assess the client's family history and other medical conditions, and review diet as well as lifestyle patterns (e.g., number of hours engaged in sedentary activities) in order to enable the patients and their families to develop goals for behavior modification. Team members record patient result data on a collection form known as the Pediatric Obesity Assessment Tool. Based on that information, the authors analyzed results from 174 patients with more than one program visit between June 2008 and August 2009. They note that 29.9 percent have reported reduced screen time; 79.8 percent have made some sort of lifestyle change; and 50.0 percent have decreased their BMI. In a smaller sample (93 patients), 32.2 percent have decreased their intake of sweetened beverages, and 33.3 percent have increased their intake of fruits and vegetables.
"The early descriptive results from this initiative are encouraging... this approach could be effective in clinics throughout the country," say the authors. "By giving primary care teams the tools, time, and collaborative infrastructure they need, we have created a system that can provide high-quality specialized care and improve access, and can potentially decrease costs."
This Web First paper is part of Health Affairs' in-depth examination of the epidemic of child obesity in its March edition, which is funded by the Robert Wood Johnson Foundation.
Health Affairs, published by Project HOPE, is the leading journal of health policy. Beginning in January 2010, the peer-reviewed journal appears each month in print, with additional Web First papers published weekly at http://www.healthaffairs.org/. The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.