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Published on: July 27, 2018
Designing a Healthy Lifestyle Assessment and Resource Referral System Within Pediatric Primary Care Settings
Nikolaus Schuetz1, J Nalubega Ross1, Lynette Lartey1
1Division of Health Services and Outcomes Research, Children's Mercy, Kansas City, MO, USA.
Insights
A trusted, tailored electronic health record system can connect children to community resources for physical activity and nutrition, aiding obesity prevention. This approach helps pediatric patients meet guidelines and improve lifestyle risk factors.
Area of Science:
- Pediatric Health
- Public Health
- Health Informatics
Background:
- Childhood obesity affects 1 in 5 US children, necessitating effective primary care interventions.
- Providers need better tools to link families to obesity prevention resources.
- Electronic health record (EHR)-based screening and referral systems are explored to address this gap.
Purpose of the Study:
- To identify essential elements for an EHR-based screening and community referral system.
- To support pediatric patients in meeting physical activity and nutrition guidelines.
- To facilitate obesity prevention efforts in primary care settings.
Main Methods:
- Mixed-methods study at a large, academic pediatric medical center.
- Qualitative data from interviews (healthcare workers, community organizations, parents) and focus groups.
- Quantitative data from a provider survey (n=40), with findings triangulated.
Main Results:
- A successful screening-referral system must be trusted, sustainable, and tailored.
- Screening requires nonjudgmental, efficient conversations with personalized options.
- Referrals need a comprehensive, high-quality, updated community resource database.
Conclusions:
- Participants found value in a system linking pediatric patients to community resources for physical activity and nutrition.
- Suggestions were provided to maximize system acceptability and effectiveness.
- The study informs innovations to mitigate obesity-related lifestyle risk factors.
Background:
Approximately 1 in 5 US children have obesity. Primary care-based screening for healthy lifestyle behaviors is one way to identify children at risk of having obesity and related consequences; however, providers often lack tools to connect patients and families to obesity prevention. Our study sought to identify essential elements of an electronic health record-based screening and community referral system to help pediatric patients meet physical activity and nutrition guidelines.
Methods:
Our mixed-methods study was conducted at a large, academic pediatric medical center in a Midwestern, US city. Qualitative data included in-depth interviews with health care workers (n = 17), focus groups with community organizations (n = 15), parents and guardians of pediatric patients (n = 9), and a bioinformatics team (n = 5). Data informed a subsequent survey with health care providers (n = 40). Multiple data collection methods and participant types triangulated findings.
Results:
Participants indicated that a screening-referral system would need to be trusted, sustainable, and tailored. Screening should be anchored in a nonjudgmental conversation, streamlined and time efficient, and offer options that cater to individual circumstances and needs. Referrals to community resources would need to be sourced from a comprehensive and high-quality database, tailored to individuals' preferences, and kept up to date.
Conclusions:
Overall, participants believed a system to facilitate community referrals for physical activity and nutrition would be valuable, and suggested ways to maximize acceptability. Our study explored a way to link pediatric patients to community resources to better meet physical activity and nutrition recommendations and guides future innovations to improve obesity-related lifestyle risk factors.
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