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Integrating plan-do-check-act (pdca)-based closed-loop management into lifestyle intervention for pediatric primary
Hongxian Lv1, Tingting Xu2, Haiying Fang1
1Third Department of Pediatrics, Jinhua Maternal and Child Health Care Hospital, Jinhua, Zhejiang Province, China.
Insights
The Plan-Do-Check-Act (PDCA) model significantly improved body composition, metabolic health, and behaviors in obese children. This approach offers a feasible and effective strategy for long-term childhood obesity management.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Quality Improvement Science
Background:
- Childhood primary obesity is a significant public health concern.
- Traditional interventions often lack systematic individualization for long-term success.
- The Plan-Do-Check-Act (PDCA) cycle offers a continuous quality improvement framework.
Purpose of the Study:
- To retrospectively evaluate the effectiveness of the PDCA closed-loop management model in childhood primary obesity.
- To compare PDCA management against routine care for obese children.
Main Methods:
- Retrospective analysis of 100 children with primary obesity, divided into PDCA (n=50) and routine care (n=50) groups.
- 6-month observation period assessing anthropometric (BMI-Z, body fat, waist circumference), biochemical (FBG, HOMA-IR, lipid profile), and behavioral indicators (diet, screen time).
- Comparison of pre- and post-intervention data within and between groups.
Main Results:
- Significant improvements observed in the PDCA group: decreased BMI-Z score, body fat percentage, and waist circumference (P<0.05).
- Metabolic improvements included reduced LDL-C, TG, and HOMA-IR, with increased HDL-C (P<0.05).
- Behavioral changes included increased physical activity and decreased unhealthy snacking and screen time (P<0.05).
Conclusions:
- The PDCA closed-loop management model effectively improves body composition, metabolic parameters, and behaviors in obese children.
- This model facilitates individualized adjustments through continuous monitoring and evaluation.
- Integrating PDCA into lifestyle management is a feasible and effective strategy for long-term childhood obesity control.
Background:
Childhood primary obesity is a major public health issue. Traditional lifestyle interventions often fail due to lack of systematic and continuous individualization. The Plan-Do-Check-Act (PDCA) cycle, a continuous quality improvement tool, may offer a new approach for its long-term management.
Objective:
This study aimed to retrospectively compare the effectiveness of the PDCA closed-loop management model for childhood primary obesity.
Method:
This study retrospectively analyzed the clinical data of 100 children with primary obesity World Health Organization (WHO) underwent PDCA closed-loop management in the pediatric healthcare department of Jinhua maternal and child health care hospital from January 2022 to December 2024. The children's information was retrospectively collected and divided into the PDCA closed-loop management group (n = 50) and the Non-PDCA routine management group (n = 50). The observation period was 6 months. Anthropometric indicators: [weight, height (calculating body mass index z score, BMI-Z score)], body fat percentage (measured by bioelectrical impedance method), waist circumference; biochemical indicators: fasting blood glucose (FBG), fasting insulin (FINS, calculating homeostatic model assessment of insulin resistance, HOMA-IR), lipid profile [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)]; behavioral assessment: using questionnaires to evaluate dietary behavior and screen time. The differences in each indicator before and after the implementation of this management method were compared.
Result:
Compared with before treatment, all indicators improved significantly after treatment (P < 0.05): BMI-Z score, body fat percentage, and waist circumference all decreased significantly (P < 0.05). Metabolic indicators improved significantly, including LDL-C, TG, HOMA-IR, and triglyceride levels decreased, and HDL-C levels increased (P < 0.05). The questionnaire survey showed that the daily activity intensity significantly increased, and the frequency of unhealthy snack intake and daily screen time significantly decreased (P < 0.05).
Conclusion:
The PDCA closed-loop management model, through continuous monitoring, evaluation, and individualized adjustment, can significantly improve the body composition, metabolic parameters, and related behavioral habits of obese children. Integrating this into the lifestyle of children with primary obesity to achieve long-term weight management is feasible and effective.
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