A Delayed-Control Trial Examining the Impact of Body Mass Index Recognition on Obesity-Related Counseling

Abstract

Background. Rates of body mass index (BMI) calculation and plotting remain low. We examined whether providing a BMI wheel and brief education to pediatric residents and attendings would increase rates of “BMI recognition” and obesity-related counseling. Methods. A delayed-control design was used to evaluate a 20-minute intervention. A total of 1640 records of well-child visits were reviewed to determine the proportion of records in which BMI was calculated and plotted and counseling provided. Results. In clinic A, there was a significant increase in the proportion of records in which BMI was recognized from pre- to postintervention ( P < .01). No changes in clinic B occurred until after the delayed intervention. Obesity-related counseling was more likely to occur if BMI was recognized. Conclusion. Brief education and BMI wheel increased rates of BMI recognition. BMI recognition was associated with increased obesity management. Additional efforts should be incorporated to further increase BMI recognition and assist providers in treating these children.

Pediatric Residency Obesity and Overweight Training Curricula: A Systematic Review

“…11 In only 2 studies did a small portion of the participants receive repeat training. 15,16 Six of the trainings occurred in the outpatient setting, 11,15,16,18-20 2 (same study but different articles) occurred during noon conference, 10,14 and 2 occurred online. 13,21 The trainings that were done in person were led by a variety of clinicians, ranging from psychology residents to nutritionists and board-certified pediatricians (Table 1).…”

“…Most of the studies (6 of 11) looked at clinical behavior changes in the physicians, specific to patient interactions. 10,11,13,18-20 One study evaluated physician effectiveness at obesity prevention and healthy lifestyle counseling but did not comment on the results. 11 One study discussed subjective behavior changes; the residents self-reported “changes in delivery of care” including being more open-ended in questioning and making more specific recommendations.…”

“…Two studies also noted an increase in frequency of follow-up appointments. 15,20 Only one study noted an increase in referrals to subspecialists and laboratory tests ordered if obesity was recognized. 20…”

Fitwits TM Leads to Improved Parental Recognition of Childhood Obesity and Plans to Encourage Change

“…6,7,14 Less than a quarter of parents of overweight children aged 2 to 15 years reported having been told by a health professional that their child was overweight, per the 1999 through 2008 National Health and Nutrition Examination Surveys. 20 Notification to parents about their child's BMI has recently improved in practices using built-in EMR prompts and decision support, though without necessarily specifying parental buy-in.…”

Parental reactions to weight screening in young children: a randomized controlled trial

“…Because of concerns regarding parental misunderstanding of standard growth charts , alternative simplified charts have been proposed . Although use of colour‐coded traffic light charts improves parental understanding and recognition of overweight, and facilitates discussion little work has directly examined parents' perspectives of these charts , nor how best to engage them in discussion.…”