Promoting Growth Interpretation and Lifestyle Counseling in Primary Care

• Published in: The Journal of pediatrics Vol. 154; no. 4; pp. 596 - 601.e1
• Main Authors: Ariza, Adolfo J., MD, Laslo, Kathleen M., MD, MPH, Thomson, J. Scott, MLIS, Seshadri, Roopa, PhD, AM, Binns, Helen J., MD, MPH
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.04.2009; Elsevier
• Subjects: Adolescent; Anthropometry - methods; Biological and medical sciences; Body Mass Index; Chicago; Child; Child, Preschool; General aspects; Growth; Health Knowledge, Attitudes, Practice; Health Promotion; Humans; Infant; Infant, Newborn; Life Style; Medical sciences; Obesity - prevention & control; Parents; Pediatrics; Pilot Projects; Practice Patterns, Physicians; Risk Assessment; Chicago; SNAPP; Body mass index; OB; Obese; PHSTS; Systematic Nutritional Assessment in Pediatric Practice; OW; Pediatric Health Supervision Timer Software; IBW; Percent ideal body weight for height; BMI; Overweight; Pediatrics; Interpretation; Growth; Primary health care; Council; Life style
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2008.10.002

Objective To pilot a practice-directed intervention to promote growth interpretation and lifestyle counseling during child health supervision visits. Study design The intervention at 4 diverse primary care practices included education, facilitation by a practice-change leadership team, tools, and guidance from the study team. Preintervention and postintervention evaluations used were clinician interviews, in-office surveys of parents, 1-month post-visit telephone survey, visit observations, and medical record reviews. Outcomes evaluated growth interpretation documentation, clinician recognition of overweight, topic discussed at health supervision visit, and parental visit content recall and health behavior changes. Results The intervention was well accepted, and tools provided were deemed helpful. Documentation of growth interpretation was higher after intervention (pre versus post: 32% vs 87%; P < .001). Parent reports of topics discussed were similar between evaluation periods (pre versus post: growth 96% vs 99%; diet 90% vs 93%; physical activity 81% vs 85%). Observed topics at health supervision visits were similarly high and were unchanged between periods. Parental recall of topics at 1 month was also high and similar between periods. Parental report of adoption of a healthier behavior for themselves or their child at 1 month did not significantly change. Conclusions The Systematic Nutritional Assessment in Pediatric Practice intervention provides a promising model to increase interpretation and documentation of growth.