Patricia C Cheung1, Julie A Gazmararian2, Michael R Kramer3, Carolyn D Drews-Botsch4, Jean A Welsh5. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: pccheun@emory.edu. 2. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: jagazma@emory.edu. 3. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: mkram02@emory.edu. 4. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Electronic address: cdrews@sph.emory.edu. 5. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Wellness Department, Children's Healthcare of Atlanta, Atlanta, GA, USA. Electronic address: jean.a.welsh@emory.edu.
Abstract
OBJECTIVE: The Healthy Weight Counseling Maintenance of Certification (MOC) program integrates pediatrician training and clinic changes to promote use of evidence-based, diet and physical activity (PA) health messages and counseling strategies. This interrupted time series study assessed the impact of this MOC program on provision of weight-related counseling. METHODS: We randomly selected 10-15 well-child visit charts at three time points before and three time points after 102 Georgia pediatricians began the MOC in 2012-2015. Linear binomial regression compared the frequency of behavior-change goal setting and health messaging documentation (fruit/vegetable consumption, sugar-sweetened beverage consumption, out-of-home food consumption, PA, and screen time) before and after MOC participation. RESULTS: At baseline, pediatricians documented behavior-change goals with 44% of patients, with an additional 49% of patients having documented goals after their pediatrician started the MOC (99.5% confidence interval [CI]: 21-77%). Similarly, absolute increases in the proportion of patients with documentation for sugar-sweetened beverage consumption (adjusted prevalence difference [aPD]: 37%; 99.5% CI: 13-62%) and out-of-home eating were observed (aPD: 38%; 99.5% CI: 12-64%). CONCLUSION: The Healthy Weight Counseling MOC is associated with increased and sustained use of evidence-based health messages and counseling strategies. PRACTICE IMPLICATIONS: Continuing education and facilitation of system changes help improve physicians' weight-related counseling.
OBJECTIVE: The Healthy Weight Counseling Maintenance of Certification (MOC) program integrates pediatrician training and clinic changes to promote use of evidence-based, diet and physical activity (PA) health messages and counseling strategies. This interrupted time series study assessed the impact of this MOC program on provision of weight-related counseling. METHODS: We randomly selected 10-15 well-child visit charts at three time points before and three time points after 102 Georgia pediatricians began the MOC in 2012-2015. Linear binomial regression compared the frequency of behavior-change goal setting and health messaging documentation (fruit/vegetable consumption, sugar-sweetened beverage consumption, out-of-home food consumption, PA, and screen time) before and after MOC participation. RESULTS: At baseline, pediatricians documented behavior-change goals with 44% of patients, with an additional 49% of patients having documented goals after their pediatrician started the MOC (99.5% confidence interval [CI]: 21-77%). Similarly, absolute increases in the proportion of patients with documentation for sugar-sweetened beverage consumption (adjusted prevalence difference [aPD]: 37%; 99.5% CI: 13-62%) and out-of-home eating were observed (aPD: 38%; 99.5% CI: 12-64%). CONCLUSION: The Healthy Weight Counseling MOC is associated with increased and sustained use of evidence-based health messages and counseling strategies. PRACTICE IMPLICATIONS: Continuing education and facilitation of system changes help improve physicians' weight-related counseling.
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