Overcoming Obesity: Provider Reminders and Education in Pediatrics

The prevalence of pediatric overweight and obesity is rising globally (Di Cesare et al., 2019) and results in lifelong chronic health problems and an estimated annual healthcare cost of $14.1 billion (Trasande & Chatterjee, 2009). The purpose of this evidence-based practice project was to address overweight and obesity in patients between the ages of five and 12 years through the provision of provider reminders, education, and guidelines. Primary outcomes included frequency of diagnosis, frequency of patient referrals, return to see times, and frequency of patient nutrition and activity education while secondary outcomes included patient weight, body mass index (BMI), and zBMI. A review of literature was conducted, and a multimodal, nonpharmacologic approach was determined to be most effective. Over a 12-week period, pediatric patients who met specified BMI percentile criteria were flagged by nurses who supplied provider reminders. A provider education session was also conducted. Statistical analysis was performed utilizing a two-group comparison design. Pre-intervention data (n = 111) was collected on frequency of diagnosis, frequency of patient referrals, and frequency of patient nutrition and activity education and was compared to intervention data (n = 391) using a chi-square test for independence to determine if the intervention made a statistically significant impact. A statistically significant increase in number of diagnosis was found (X2 (1) = 8.636, p = .003) while the results for the frequency of nutrition and activity counseling (X2 (1) = 1.587, p = .208), return to see times (t (500) = 1.263, p = .207), and frequency of referrals (X2 (1) = 2.296, p = .317) were not significant. To examine secondary outcomes, a paired t-test comparing the weight, BMI, and zBMI of repeat patients (n = 27) was performed. While patient weight increased significantly (t = -3.620, df = 26, p = .001), this was expected as height also increased. No significant difference in BMI (t = -.792, df = 26, p = .436) or zBMI (t = .166, df = 26, p = .869) was found. Future longitudinal research should aim to examine if an increase in diagnosis contributes to decreased patient weight, BMI, and zBMI