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Evaluating Telehealth Quality Outcomes of a Pediatric Weight Management Program
Meg Simione1, Man Luo2, Jorge A Rodriguez3,4
1Department of Communicative Disorders, College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA.
Insights
Telehealth quality for children with obesity is linked to public insurance, social risks, and non-English preferred languages. These factors can help reduce health disparities in pediatric weight management.
Area of Science:
- Pediatric Health
- Health Services Research
- Telemedicine
Background:
- Telehealth adoption in pediatric weight management is increasing.
- Understanding patient-level factors influencing telehealth quality is crucial for equitable care.
- Children with obesity face unique challenges in accessing consistent healthcare services.
Purpose of the Study:
- To assess how patient characteristics impact telehealth quality outcomes in pediatric obesity care.
- To identify disparities in telehealth service delivery for children with obesity.
- To inform the development of equitable and effective telehealth programs.
Main Methods:
- A retrospective analysis of telehealth visits for children with obesity in an academic medical center.
- Inclusion of patient-level data: insurance type, social determinants of health (SDOH) screener status, and preferred language.
- Multivariable logistic regression to analyze associations between patient characteristics and quality outcomes (BMI documentation, tool usage, visit mode).
Main Results:
- Children with public insurance showed higher odds of BMI documentation, Connect for Health tool usage, and audio-only visits.
- Patients with social risk factors had increased odds of BMI documentation.
- Those with a non-English preferred language were more likely to have audio-only visits.
Conclusions:
- Patient characteristics including insurance type, social risk factors, and preferred language are associated with telehealth quality outcomes.
- Telehealth interventions can be designed to mitigate health disparities in pediatric weight management.
- Findings highlight the need for tailored telehealth strategies to ensure high-quality, equitable care for all children with obesity.
Objective:
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.
Methods:
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.
Results:
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).
Conclusion:
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.
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