Childhood Obesity: Developing Early Nutrition & Feeding Education for Parents at Well Child Visits

Childhood obesity is an extensive problem in the United States and North Dakota (CDC, 2014). Significant health consequences are linked to obesity, including type two diabetes, hypertension, hyperlipidemia, cardiovascular disease, cancers, and psychological disorders (Pandita et al., 2016; Xu & Mishra, 2018). Obesity comorbidities, previously presented in later adulthood, now emerge in younger populations (Pandita et al., 2016). Unfortunately, treatment of obesity is not effective, and therefore, prevention must be the primary focus (Daniels et al., 2015; Pandita et al., 2016). Diet and eating behaviors have a significant impact on weight, and children develop taste preferences and lifelong eating behaviors within the first few years of life (Birch & Anzman, 2010; Daniels et al., 2015; IOM, 2011). Therefore, targeting interventions on feeding and nutrition in infancy may foster healthy habits for life and play a role in the prevention of obesity. Responsive feeding interventions hold promise in supporting healthy growth. Ellyn Satter?s Division of Responsibility promotes the responsive feeding relationship between parent and child. The purpose of the practice improvement project was to address childhood obesity prevention through the development of an educational curriculum on feeding and nutrition. The parent-focused education correlated with each well child visit (WCV) between the ages of two weeks and three years. A multidisciplinary team of representatives from pediatrics, behavioral health, and patient education was consulted to develop the education. Ten providers at Midwestern primary care clinics reviewed the educational curriculum and provided feedback on the content and methods to deliver the education to parents. Most providers found the content to be accurate (n = 7; 70%) and comprehensive (n = 8; 80%). Three providers suggested expanding on topics such as breastfeeding and mixing formula. Providers unanimously agreed that the curriculum is relevant and understandable. A formal literacy evaluation resulted in grade-level readability scores between the 6th and 8th-grade levels. Almost all providers (n = 9) believed the curriculum would be valuable for use in practice. The preferred delivery method chosen was one on one provider to parent education. The project clinic plans to pilot the curriculum with parents attending infant and toddler WCVs