Effective Implementation of Culturally Appropriate Tools in Addressing Overweight and Obesity in an Urban Underserved Early Childhood Population in Pediatric Primary Care

Clin Pediatr (Phila). 2019 May;58(5):511-520. doi: 10.1177/0009922819832088. Epub 2019 Mar 6.

Abstract

Overweight and obese children are at an increased risk of remaining obese. The American Academy of Pediatrics recommends addressing healthy habits at well-child checks, but this poses challenges, especially in low-income populations. A clinical innovation project was designed to adapt recommendations in a busy urban clinic and consisted of motivational interviewing, culturally tailored tools, and standardizing documentation. A quasi-experimental design examined innovation outcomes. Of 137 overweight and obese children aged 24 to 66 months, providers' documentation of weight during well-child check visits improved post-innovation ( P < .01), as did development of healthy habits goals ( P < .001). Families were more likely to return for visits post-innovation ( P = .01). A logistic regression analysis showed that adding body mass index to the problem list and establishing a specific follow-up timeframe most predicted follow-up visits to assess progress ( P < .001). Comprehensive innovations consisting of motivational interviewing, implementation of culturally tailored tools, and standardized documentation can enhance engagement in an urban clinic setting.

Keywords: early childhood; early intervention; motivational interviewing; obesity; overweight; pediatric primary care.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Child
  • Child, Preschool
  • Culturally Competent Care
  • Early Medical Intervention / methods*
  • Female
  • Follow-Up Studies
  • Health Promotion / methods*
  • Healthy Lifestyle
  • Humans
  • Logistic Models
  • Male
  • Motivational Interviewing
  • Pediatric Obesity / diagnosis*
  • Pediatric Obesity / economics
  • Pediatric Obesity / therapy*
  • Pediatrics / methods*
  • Poverty
  • Primary Health Care / methods*
  • Urban Health
  • Vulnerable Populations