Implementation of an Obesity Screening/Intervention Program at a College Student Health Clinic

Obesity is a serious health epidemic that is a concern to numerous health agencies and providers. The prevalence of obesity continues to increase in all demographics and is associated with numerous non-communicable diseases (NCDs), early mortality, and excessive healthcare costs. In 2012, the United States Preventative Services Task Force (USPSTF) gave a strong recommendation to screen all adults for obesity and to refer those with a Body Mass Index (BMI) of 30 kilograms per meter squared (kg/m2) or higher to intensive weight management programs. A thorough review of the literature shows that active obesity screening, with appropriate intervention and management, has been shown to reduce complications of associated NCDs, reduce the risk of premature death, and improve health and quality of life. Despite the USPSTF recommendations and the increased incidence and prevalence of obesity, a large majority of primary care clinics and providers fail to screen for obesity due to a variety of barriers. Furthermore, the literature shows that the college student population is vastly understudied when it comes to obesity, and has many unique challenges that increase the likelihood of obesity. The aim of this project was to successfully implement an obesity screening/intervention program using evidence based recommendations at a local college health clinic, to improve adherence to USPSTF recommendations, increase provider awareness, and improve the health of the patient population. A baseline chart review of wellness exams was used to identify current adherence to USPSTF recommendations, and showed that only 25% of patients with BMI of 30 kg/m2 or higher were diagnosed with obesity or had documentation of an appropriate plan. Following the baseline chart review, an introductory meeting with frontline clinical staff was held to introduce the project, share baseline results, explore staff educational needs, identify potential barriers to obesity screening/intervention, and obtain input on using an electronic health record (EHR) alert to encourage consistent obesity screening/ intervention. A resource guide that included campus and community resources, as well as thoroughly researched electronic applications, books, and websites aimed at intensive weight management was created for clinical staff to offer patients. Two months after implementation of the EHR alert and dissemination of the resource guide, a post-implementation chart review of wellness exams was conducted, and showed that 90.9 % of patients with a BMI of 30 kg/m2 or higher were diagnosed with obesity and had documentation of an appropriate plan. Comparison of baseline and post-implementation rates results were reported to the clinic director and staff. Obesity screening/intervention programs in college health clinics encourage providers to assist obese patients at a formative stage of life. Obese college students who establish healthier lifestyle behaviors reduce their risk for NCDs associated with obesity, reduce medical costs associated with obesity, and improve their health-related quality of life