Introduction: Obesity risk may be lessened through the promotion of early childhood practices that protect against unhealthy weight gain. Although health information technology (HIT) has been used to target adherence to recommendations for children with elevated BMI, little is known about HIT to support obesity prevention from birth through 36 months. Methods: We conducted an environmental scan and an expert stakeholder meeting to explore the question, "What HIT exists to support provision of guidance surrounding appropriate feeding practices, optimal nutrition, and obesity prevention by the medical team for children without underlying medical conditions ages birth through the third birthday?" The environmental scan was developed in consultation with a medical librarian, and included a computerized search of PubMed, Google Scholar, and ClinicalTrials.gov for articles involving HIT interventions potentially applicable to children 0-36 months old that address nutrition, feeding, or obesity prevention. We included studies of older children and obesity interventions in anticipation that lessons could be learned from these studies for our population of interest. Using a two-step screening process performed by a single reviewer, articles meeting study inclusion criteria were collated into two sub-sets: (1) optimal nutrition, appropriate feeding practices, and/or obesity prevention, and (2) recognition, management, or treatment of abnormal weight gain. Articles retained after full-text screen were categorized by theme and intervention-delivery mechanism. Initial findings of the environmental scan were presented at a stakeholder meeting that included a nutrition researcher affiliated with WIC, representatives from the CDC and AAP, and pediatricians with expertise in childhood obesity and informatics (n=13). Participants were asked to identify innovative ways HIT could address obesity prevention, optimal nutrition, and appropriate feeding practices in children 0-36 months old. Methods used to facilitate innovation included think-out-loud discussions and pair-and-share sessions focused on specific themes. Results: Of 445 articles identified in the environmental scan, 70 underwent full-text screening and 56 met study inclusion criteria: 43% reported interventions falling into the primary sub-set (e.g., optimal nutrition) and 57% reporting interventions to recognize/manage patients with elevated BMI. Classification of publications by theme/intervention-delivery mechanism is depicted in Table 1. During our stakeholder meeting, HIT interventions discussed included: improving display of relevant data, using pre-visit surveys, personalizing anticipatory guidance, minimizing duplicative tasks, direct-to-patient applications, and data sharing among medical home, WIC, and other community or referral networks. Stakeholders noted that barriers to developing such interventions include need for consensus regarding the best screening surveys and consistent messages targeting obesity prevention assessment and education in the first 36 months of life. Conclusion: Few HIT interventions target optimizing nutrition, appropriate feeding practices, or obesity prevention in children within the first 36 months of life. This study identified numerous promising HIT-based innovations that could be tested during the first 36 months of life.
Health Information Technology to Support Optimal Nutrition, Appropriate Feeding Practices and Obesity Prevention in the First 36 Months of Life: Environmental Scan and Stakeholder Meeting Findings
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Jeremy Michel, Mona Sharifi, Julia Richerson, Jennifer Groos, Julie Reeder, Christy B. Turer, Eileen Reilly, Jeanne Lindros, Mala Thapar, Lisa Krams; Health Information Technology to Support Optimal Nutrition, Appropriate Feeding Practices and Obesity Prevention in the First 36 Months of Life: Environmental Scan and Stakeholder Meeting Findings. Pediatrics July 2020; 146 (1_MeetingAbstract): 86–87. 10.1542/peds.146.1MA1.86b
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