Introduction: Childhood obesity remains a serious public health threat. There is an urgent need for innovative, effective, and sustainable interventions for childhood obesity that are pragmatic, multisector and integrated. Using the Primary Care Obesity Network (PCON), a network of primary care practices linked to a tertiary care obesity center at a children’s hospital to prevent and treat childhood obesity, we describe translation of the 2007 Expert Committee treatment stages into practice and integration of the interventions across primary care, tertiary care, and community settings. Case Report: Primary care practices in the network offer patients and families the first 2 stages of care recommended by the 2007 Expert Committee guidelines. The network of primary care practices is then linked to a hospital-based comprehensive tertiary care obesity center that provides Stage 3 and 4 treatments. The second objective of the network is to create clinic-community linkages by establishing a patient-centered medical neighborhood (PCMN) that recognizes and supports the care of the patient within and outside the health care system. The tertiary care center serves as the integrator for all the activities of the network. Figure 1 provides a schematic representation of the stages. Measures tracked include process (e.g., utilization rate), program (e.g., growth of network) and patient (e.g., anthropometrics) outcomes. Discussion: All stages of care have been translated into practice in the community. Dietitians serve as the allied health care professionals in the stage 2 clinics. PCON practices are located in 20 primary practices and 13 school-based clinics, with a total of 165 pediatricians and nurse practitioners. Seven primary care practices and 11 school clinics are located in zip codes with a high vulnerable footprint defined as ≥ 15% with less than a high school diploma and ≥ 20% of the population living below poverty. Mean utilization rate in the clinics for 2017 was 43.4% (range 21.1-65.5%). In a subset of clinics, Figure 2a and 2b show reported risk factors and accompanying goals. Over a two-year period, 58% of patients who had 4 or more visits over 6 months decreased their body mass index. We also established a patient-centered medical neighborhood through building relationships with over 12 community organizations. Challenges include sustainable funding, especially for dietitians, patient retention, practice variation and changes in community partnerships. We will present updated outcomes over a 5-year period. Conclusion: The PCON experience is a real-life, replicable, and innovative approach to translating all the expert committee stages of care into practice within a community. Further research on enhancing retention and standardizing outcomes is needed.
The Primary Care Obesity Network: Translating Expert Committee Guidelines on Childhood Obesity Into Practice
- Views Icon Views
- Share Icon Share
- Search Site
Ihuoma Eneli, Megan E. Rose, Mary Ann Abrams, Candace Howell, Phyllis Polas; The Primary Care Obesity Network: Translating Expert Committee Guidelines on Childhood Obesity Into Practice. Pediatrics August 2019; 144 (2_MeetingAbstract): 220. 10.1542/peds.144.2MA3.220
Download citation file: