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Implementation of the Connect for Health pediatric weight management program: study protocol and baseline
Meg Simione1,2, Haley Farrar-Muir1, Fernanda Neri Mini1
1Division of General Pediatrics, MassGeneral Hospital for Children, Boston, MA 02114, USA.
Insights
The Connect for Health intervention aims to improve outcomes for low-income children aged 2-12 with obesity. Pre-implementation data show gaps in recommended care, highlighting the need for better weight management program uptake.
Area of Science:
- Pediatric primary care
- Public health interventions
- Obesity management in children
Background:
- Low-income children aged 2-12 with BMI ≥85th percentile often lack recommended diagnosis codes, referrals, and laboratory evaluations.
- Current approaches may not adequately support the uptake of effective weight management programs for pediatric obesity.
- Family-centered outcomes are a key focus for improving pediatric health in primary care settings.
Purpose of the Study:
- To evaluate the 'Connect for Health' intervention using the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework.
- To examine the effectiveness of stakeholder-informed strategies on program adoption and child outcomes.
- To describe characteristics of children with elevated BMI and associated care practices.
Main Methods:
- Mixed-methods evaluation guided by the RE-AIM framework.
- Analysis of pre-implementation data for children (ages 2-12) with BMI ≥85th percentile.
- Assessment of primary care practices related to obesity management.
Main Results:
- A significant number of children (26,161) with BMI ≥85th percentile received primary care visits prior to intervention.
- A majority of these children lacked essential elements of obesity care, including diagnosis codes, referrals, and lab evaluations.
- Findings underscore deficiencies in current pediatric obesity care practices.
Conclusions:
- The 'Connect for Health' intervention is being implemented to address gaps in pediatric obesity care.
- Stakeholder-informed strategies are crucial for successful intervention adoption and improving child health outcomes.
- Enhanced approaches are necessary to increase the utilization of evidence-based weight management programs for children.
Abstract:
We are implementing Connect for Health, a primary care-based intervention to improve family-centered outcomes for children, ages 2-12 years, in organizations that care for low-income children. We will use the 'Reach-Effectiveness-Adoption-Implementation-Maintenance' framework to guide our mixed-methods evaluation to examine the effectiveness of stakeholder-informed strategies in supporting program adoption and child outcomes. We also describe characteristics of children, ages 2-12 years with a BMI ≥85th percentile and obesity-related care practices. During the period prior to implementation, 26,161 children with a BMI ≥85th percentile were seen for a primary care visit and a majority lacked recommended diagnosis codes, referrals and laboratory evaluations. The findings suggest the need to augment current approaches to increase uptake of proven-effective weight management programs. Clinical trial registration number: NCT04042493 (Clinicaltrials.gov), Registered on 2 August 2019; https://clinicaltrials.gov/ct2/show/NCT04042493.
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