Appointment Attendance in a Pediatric Weight Management Clinic

Halvorson, Elizabeth E.; Skelton, Joseph A.

doi:10.1177/0009922811410876

Cited by 20 publications

(26 citation statements)

References 12 publications

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“…Brenner FIT uses a prospective, clinical database to track outcomes and patient progress 13,14 and includes most clinical data from the intake visit, with follow-up data entered every 4 months during physician reassessment. This retrospective study measured changes in patient enrollment from rural areas ( > 60 miles from Brenner FIT in an area of low population density) and in outcomes (attrition from treatment, improvements in BMI z-score) before and after the application of telemedicine technology.…”

Section: Methodsmentioning

confidence: 99%

TeleFIT: Adapting a Multidisciplinary, Tertiary-Care Pediatric Obesity Clinic to Rural Populations

Irby

Boles

Jordan

et al. 2012

Telemedicine and e-Health

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Pediatric obesity occurs most frequently in underserved communities where families have difficulty accessing healthcare. Disproportionate obesity rates in rural children denote significant disparities warranting innovative solutions. However, intensive, tertiary-care treatment options outlined in recent expert recommendations may not be available to families living in rural areas. Telemedicine may be useful for providing pediatric obesity treatment to rural families. The aim of this study was to assess the impact of a new outreach program (TeleFIT), which placed telemonitors in four rural satellite clinics to increase access to a pediatric obesity clinic (Brenner Families In Training [FIT]). Before TeleFIT began, of five patients from rural counties enrolled in treatment over a 1-year period, all dropped out by their third visit. Within the first year of TeleFIT, the number of rural patients increased nearly threefold (to 14) and increased again in the second year by an additional 16 new patients (n = 35). Preliminary outcomes indicate comparable attrition rates and improvement in weight status compared with patients in conventional treatment. Telemedicine allows rural families to access intensive obesity treatment from local pediatric offices, eliminating geographic barriers. Systems delivering state-of-the-art care in rural areas have tremendous potential for reducing health disparities in rural populations. Further research is needed to test the efficacy of such interventions.

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Section: Methodsmentioning

confidence: 99%

TeleFIT: Adapting a Multidisciplinary, Tertiary-Care Pediatric Obesity Clinic to Rural Populations

Irby

Boles

Jordan

et al. 2012

Telemedicine and e-Health

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“…Obesity treatment involves frequent clinical appointments [11], and lack of regular or reliable transportation causes missed visits [34] and increased attrition [35]. To address this challenge, Brenner FIT built upon an existing relationship with a primary care partner (an urban, non-profit health center affiliated with the medical center) which provides transportation vouchers for patients.…”

Section: Transportationmentioning

confidence: 99%

Community engagement and pediatric obesity: Incorporating social determinants of health into treatment

Skelton

Palakshappa

Moore

et al. 2019

J. Clin. Trans. Sci.

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Childhood obesity is a complex and multi-faceted problem, with contributors ranging from individual health behaviors to public policy. For clinicians who treat pediatric obesity, environmental factors that impact this condition in a child or family can be difficult to address in a clinical setting. Community-clinic partnerships are one method to address places and policies that influence a person’s weight and health; however, such partnerships are typically geared toward community-located health behavior change rather than the deeper social determinants of health (SDH), limiting effective behavioral change. Community-engaged research offers a framework for developing community-clinic partnerships to address SDH germane to obesity treatment. In this paper, we discuss the relationship between SDH and pediatric obesity treatment, use of community-clinic partnerships to address SDH in obesity treatment, and how community engagement can be a framework for creating and harnessing these partnerships. We present examples of programs begun by one pediatric obesity clinic using community-engagement principles to address obesity.

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“…Content of satisfaction survey questions were categorized based on dimensions of patient satisfaction identified in previous studies, accessibility, physical environment, materials and resources, clinician-patient interactions, treatment/outcomes, convenience, cost, duration, and overall satisfaction (Margolis, Al-Marzouq, Revel, & Reed, 2003;Pascoe & Attkisson, 1983;Ware, Snyder, Wright, & Davies, 1983;Woolley, Kane, Hughes, & Wright, 1978). We also included a short measure of satisfaction developed for quality improvement in our own clinic, designed to assess each of the aforementioned dimensions of satisfaction (Guzman, Irby, Pulgar, & Skelton, 2011;Halvorson & Skelton, 2011;Irby, Kaplan, Garner-Edwards, Kolbash, & Skelton, 2010;Skelton, Goff et al, 2011). This measure has not yet been published and was used solely for quality improvement purposes (Skelton, Irby, & Beech, 2011).…”

Section: Satisfaction Survey Analysismentioning

confidence: 99%

“…Authors from the remaining nine studies kindly provided their satisfaction surveys. Table 3 describes the satisfaction domains and features assessed across these studies, including the satisfaction survey used in our pediatric weight management clinic (Halvorson & Skelton, 2011;Irby et al, 2010;Skelton, Goff et al, 2011).…”

Section: Satisfaction Measuresmentioning

confidence: 99%

A Systematic Review of Satisfaction and Pediatric Obesity Treatment: New Avenues for Addressing Attrition

Skelton

Irby

Geiger

2014

Journal for Healthcare Quality

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Pediatric obesity treatment programs report high attrition rates, but it is unknown if family experience and satisfaction contributes. This review surveys the literature regarding satisfaction in pediatric obesity and questions used in measurement. A systematic review of the literature was conducted using Med-line, PsychINFO, and CINAHL. Studies of satisfaction in pediatric weight management were reviewed, and related studies of obesity were included. Satisfaction survey questions were obtained from the articles or from the authors. Eighteen studies were included; 14 quantitative and 4 qualitative. Only one study linked satisfaction to attrition, and none investigated the association of satisfaction and weight outcomes. Most investigations included satisfaction as a secondary aim or used single-item questions of overall satisfaction; only one assessed satisfaction in noncompleters. Overall, participants expressed high levels of satisfaction with obesity treatment or prevention programs. Surveys focused predominantly on overall satisfaction or specific components of the program. Few in-depth studies of satisfaction with pediatric obesity treatment have been conducted. Increased focus on family satisfaction with obesity treatment may provide an avenue to lower attrition rates and improve outcomes. Enhancing measurement of satisfaction to yield actionable responses could positively influence outcomes, and a framework, via patient-centered care principles, is provided.

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Appointment Attendance in a Pediatric Weight Management Clinic

Cited by 20 publications

References 12 publications

TeleFIT: Adapting a Multidisciplinary, Tertiary-Care Pediatric Obesity Clinic to Rural Populations

TeleFIT: Adapting a Multidisciplinary, Tertiary-Care Pediatric Obesity Clinic to Rural Populations

Community engagement and pediatric obesity: Incorporating social determinants of health into treatment

A Systematic Review of Satisfaction and Pediatric Obesity Treatment: New Avenues for Addressing Attrition

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