Evaluating Telehealth Quality Outcomes of a Pediatric Weight Management Program

To examine the extent to which patient-level characteristics are associated with telehealth quality outcomes (representing economic, functional, and equity outcomes) for children with obesity seen in primary care.

We evaluated the Connect for Health pediatric weight management program adapted for telehealth in an academic medical center in Boston, MA. Patient-level characteristics included insurance type, status of the social determinants of health screener, and preferred language. The outcomes were body mass index (BMI) documentation, Connect for Health tool usage, and mode of visit. We conducted multivariable logistic regression.

We included 417 children who had a telehealth visit. Children had a mean (SD) age of 7.1 (2.9) years, 72% had public insurance, 35% spoke a language other than English, and 24% had one or more social risk factors. Children with public insurance, compared to private insurance, had higher odds of having their BMI documented (odds ratio [OR]: 3.12; 95% confidence interval [CI]: 1.04, 9.34), having had a clinician use the Connect for Health tools (OR: 2.08; 95% CI: 1.16-3.74), and having an audio-only visit (OR: 1.93; 95% CI: 1.14-3.27). Children with social risk factors, compared to no risk factors, had higher odds of having their BMI documented (OR: 3.35; 95% CI: 1.02-11.07). Children with a preferred language other than English compared to English had higher odds of having an audio-only visit (OR: 1.88; 95% CI: 1.18-2.99).

We found associations between telehealth quality outcomes and children having public insurance, social risk factors, and a preferred language other than English. The findings suggest that telehealth programs can be developed to overcome known health disparities and achieve high-quality care.