Assist Clinical Practices in Treating Overweight Children

Child health care providers often fail to detect overweight children and fail to address behaviors that lead to progressive unhealthy weight gain in the office setting. Further, the process of behavior change often requires repeated contacts to address external or family pressures that may eliminate or reduce the ability of the child and family to adopt healthy behaviors suggested during the clinical encounter. Repeated contacts are often outside the scope of the medical office. Without help to assess the cause of behavior change failure or help to identify strategies to overcome barriers to healthy behaviors, the chances of families making needed behavior change on their own is low.

A comprehensive, multifaceted model for obesity detection and intervention in primary care settings is under development. The model consists of 1) improved identification of overweight and at risk for overweight patients, 2) clinicians informed on the management of overweight patients who provide effective counseling and routine secondary evaluations, 3) training clinicians in behavior modification techniques for use in clinical care, and 4) home-assisted patient/family behavior change by providing phone and/or web-based support. Development and pilot testing of aspects of this model is progressing well. Still lacking is the testing of a home-based support program to help a family understand the contributors to the overweight problem and make decisions about how best to adopt healthy behaviors. Currently there are no known, tested home-based approaches to lifestyle intervention for children that could accompany office-based care to help a child and the family replace old habits with healthier ones. This proposal seeks support for the development and feasibility testing of such a program. The proposed program would include a personal encounter with a “Lifestyle Coach,” to review and/or expand upon health habits identified by the clinics and provide support for health goals set in the clinic or identify new goals. Subsequent support will be tailored to that family’s needs and provide by telephone, email or in-person visits as preferred by the participant and family.

Successful development and implementation of this program could have important implications for clinical practice by first demonstrating feasibility of this model and providing preliminary data necessary for submission of a larger pilot study proposal to a national funding agency that could test the overall efficacy and cost of this approach in the broader clinical context. 

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