Bonnie Gance-Cleveland1, Heather Aldrich2, Sarah Schmiege3, Karen Tyler2. 1. College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA bonnie.gance-cleveland@ucdenver.edu. 2. College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 3. Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Abstract
OBJECTIVE: The purpose of this study was to evaluate school-based health center (SHBC) provider adherence to guidelines for identification and assessment of childhood obesity after participation in a virtual Health Disparities Learning Collaborative with and without HeartSmartKids™, decision-support technology with tailored patient education. DESIGN AND SETTING: A cluster randomized comparative effectiveness trial was conducted with 24 SBHCs from six states. PARTICIPANTS: The sample consisted of 33 SBHC providers and review of medical charts at three time points. Chart data were collected at baseline (n = 850), after training (n = 691) and 6 months after training (n = 612). MAIN OUTCOME MEASURES: Charts from a random sample of youth 5-12 years making well-child visits were examined for the documentation of: BMI percentile, accurate weight diagnosis based upon BMI percentile, blood pressure percentile, and ordering appropriate laboratory assessment of obese youth ≥10 years old. RESULTS: Percentage of overweight/obese children in this study was 40.4-47.2%. For both the HeartSmartKids™ and non-HeartSmartKids™ groups, provider adherence significantly improved after training for BMI percentile and blood pressure percentile documentation, as well as correct diagnosis for overweight and obese. Implementation of the HeartSmartKids™ was variable at the technology sites and differences in identification and assessment were not found between groups. CONCLUSION: The virtual collaborative approach to quality improvement resulted in improved adherence to guidelines for identification and assessment of overweight/obese children. The impact of the training with and without HeartSmartKids™ on patient outcomes needs to be evaluated. Coaching on implementation of technology needs to be included in future work.
RCT Entities:
OBJECTIVE: The purpose of this study was to evaluate school-based health center (SHBC) provider adherence to guidelines for identification and assessment of childhood obesity after participation in a virtual Health Disparities Learning Collaborative with and without HeartSmartKids™, decision-support technology with tailored patient education. DESIGN AND SETTING: A cluster randomized comparative effectiveness trial was conducted with 24 SBHCs from six states. PARTICIPANTS: The sample consisted of 33 SBHC providers and review of medical charts at three time points. Chart data were collected at baseline (n = 850), after training (n = 691) and 6 months after training (n = 612). MAIN OUTCOME MEASURES: Charts from a random sample of youth 5-12 years making well-child visits were examined for the documentation of: BMI percentile, accurate weight diagnosis based upon BMI percentile, blood pressure percentile, and ordering appropriate laboratory assessment of obese youth ≥10 years old. RESULTS: Percentage of overweight/obesechildren in this study was 40.4-47.2%. For both the HeartSmartKids™ and non-HeartSmartKids™ groups, provider adherence significantly improved after training for BMI percentile and blood pressure percentile documentation, as well as correct diagnosis for overweight and obese. Implementation of the HeartSmartKids™ was variable at the technology sites and differences in identification and assessment were not found between groups. CONCLUSION: The virtual collaborative approach to quality improvement resulted in improved adherence to guidelines for identification and assessment of overweight/obesechildren. The impact of the training with and without HeartSmartKids™ on patient outcomes needs to be evaluated. Coaching on implementation of technology needs to be included in future work.
Authors: Supriya Mohile; Marie Anne Bakitas; Lisa Zubkoff; Kathleen Doyle Lyons; J Nicholas Dionne-Odom; Gregory Hagley; Maria Pisu; Andres Azuero; Marie Flannery; Richard Taylor; Elizabeth Carpenter-Song Journal: Implement Sci Date: 2021-03-11 Impact factor: 7.327