Creating an integrated care model for childhood obesity: a randomized pilot study utilizing telehealth in a community...

Area of Science:

• Pediatrics
• Public Health
• Digital Health

Background:

• Childhood obesity is a growing public health concern requiring innovative treatment strategies.
• Integrated care models involving primary care providers (PCPs) and specialists can improve management of complex conditions like obesity.
• Telehealth offers a potential solution to overcome access barriers in pediatric obesity care.

Purpose of the Study:

• To evaluate the effectiveness of an integrated care model using telehealth for treating childhood obesity.
• To compare changes in body mass index (BMI) in children receiving combined PCP and specialist tele-visits versus PCP visits alone.

Main Methods:

• A pilot study with 40 children (10-17 years, BMI ≥95th percentile) randomized into two groups.
• Group 1 received PCP visits + specialist tele-visits for 6 months, then PCP visits only. Group 2 received PCP visits only for 6 months, then PCP visits + specialist tele-visits.
• Both groups had ongoing tele-consultation between PCPs and obesity specialists, with regular PCP visits over 12 months.

Main Results:

• At 3 months, BMI z-score decreased more in the group starting with specialist tele-visits (-0.11) compared to the group with PCP visits only (-0.05).
• At 6 months, BMI was significantly lower than baseline in the group that initially received specialist tele-visits (-0.11), but not in the other group (-0.06).
• Following crossover, BMI remained lower than baseline for the group that started with tele-visits and dropped below baseline for the group that started with PCP visits only.

Conclusions:

• An integrated care model incorporating telehealth is a promising approach for managing childhood obesity.
• Telehealth can enhance the effectiveness of obesity treatment by improving access to specialist care.
• This model demonstrates potential for sustained BMI reduction in pediatric patients.