Integration of a Pediatric Cardiovascular Health Model Within the Primary Care Setting

Cardiovascular diseases are a chronic pandemic and leading cause of mortality globally. This pandemic has been studied thoroughly and it is well known that approximately 80% of cardiovascular diseases are preventable through maintenance of healthy lifestyles and early detection of risk beginning in childhood. Because the majority of children are born with healthy cardiovascular systems, the role of the pediatric primary care provider is to identify and manage such risk factors including obesity. There is extensive literature regarding barriers to obesity prevention and management including lack of clinician diagnosis of overweight or obesity, limited time for cardiovascular screening and education, low referral rates for obesity management, clinician knowledge deficits of current guidelines, and clinician challenges to discussing body mass index due to social stigma. The aim of this project was to address these barriers through implementation of a cardiovascular health model integrated within the electronic health record to streamline the process of risk assessment and management. The goal was to aid pediatric provider conversations regarding lifestyle behavior modifications and to translate research into practice through improved rates of overweight or obesity diagnosis, nutrition or weight management referrals, and lipid screening. The intervention improved lipid screening rates for both clinicians but obesity diagnosis and referrals were inconsistent. Data analysis indicates a key area for clinical improvement is focus on early childhood and pre-pubescent body mass index elevations as a predictor for adolescent obesity and to invest time in cardiovascular health maintenance education instead of managing efforts to reverse obesity