Identification of Overweight and Obesity in Low-Income Minority Children by Pediatric Providers and Child...

Area of Science:

• Pediatrics
• Public Health
• Health Informatics

Background:

• Childhood overweight and obesity present a significant public health challenge.
• Accurate coding by pediatric primary care providers (PCPs) is crucial for effective obesity management and prevention.
• Identifying factors influencing coding accuracy is essential for improving care in urban, minority populations.

Purpose of the Study:

• To identify characteristics associated with correct coding of overweight and obese children (ages 2-9).
• To evaluate the impact of a provider training intervention on coding consistency.
• To inform targeted strategies for enhancing the implementation of obesity guidelines.

Main Methods:

• Analysis of electronic health records from 15 PCPs before and after an intervention.
• Inclusion of pre- (n=262) and post-intervention (n=244) patient data.
• Descriptive statistics and simple logistic regression were used to analyze coding accuracy.

Main Results:

• Children with obese body mass index percentiles were more likely to be coded correctly compared to those who were overweight.
• Older children (compared to toddlers) were also more consistently coded correctly.
• Provider characteristics did not show an association with correct coding accuracy.

Conclusions:

• Provider training led to improvements in coding for overweight and obese children.
• Despite improvements, a significant number of cases remained uncoded or miscoded.
• Understanding factors associated with missed coding can guide future training to ensure fidelity to evidence-based obesity guidelines.