Omoye E Imoisili1, Elizabeth A Lundeen2, David S Freedman2, Lindsay S Womack3, Jessica Wallace4, Simon J Hambidge4, Steven Federico4, Rachel Everhart4, Delia Harr4, Jillian Vance4, Lyudmyla Kompaniyets2, Carrie Dooyema2, Sohyun Park2, Heidi M Blanck5, Alyson B Goodman5. 1. Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity (OE Imoisili, EA Lundeen, DS Freedman, L Kompaniyets, C Dooyema, S Park, HM Blanck, and AB Goodman), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga; Epidemic Intelligence Service (OE Imoisili and LS Womack), Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service (OE Imoisili, LS Womack, HM Blanck, and AB Goodman), Rockville, Md. Electronic address: omoye.imoisili@gmail.com. 2. Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity (OE Imoisili, EA Lundeen, DS Freedman, L Kompaniyets, C Dooyema, S Park, HM Blanck, and AB Goodman), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga. 3. Epidemic Intelligence Service (OE Imoisili and LS Womack), Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service (OE Imoisili, LS Womack, HM Blanck, and AB Goodman), Rockville, Md. 4. Denver Health Ambulatory Care Services (J Wallace, SJ Hambidge, S Federico, R Everhart, D Harr, and J Vance), Denver, Co. 5. Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity (OE Imoisili, EA Lundeen, DS Freedman, L Kompaniyets, C Dooyema, S Park, HM Blanck, and AB Goodman), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service (OE Imoisili, LS Womack, HM Blanck, and AB Goodman), Rockville, Md.
Abstract
OBJECTIVE: The Mind, Exercise, Nutrition, Do It! 7-13 (MEND 7-13) program was adapted in 2016 by 5 Denver Health federally qualified health centers (DH FQHC) into MEND+, integrating clinician medical visits into the curriculum and tracking health measures within an electronic health record (EHR). We examined trajectories of body mass index (BMI, kg/m2) percentile, and systolic and diastolic blood pressures (SBP and DBP) among MEND+ attendees in an expanded age range of 4 to 17 years, and comparable nonattendees. METHODS: Data from April 2015 to May 2018 were extracted from DH FQHC EHR for children eligible for MEND+ referral (BMI ≥85th percentile). The sample included 347 MEND+ attendees and 21,061 nonattendees. Mixed-effects models examined average rate of change for BMI percent of the 95th percentile (%BMIp95), SBP and DBP (mm Hg), after completion of the study period. RESULTS: Most children were ages 7 to 13 years, half were male, and most were Hispanic. An average of 4.2 MEND+ clinical sessions were attended. Before MEND+, %BMIp95 increased by 0.247 units/month among MEND+ attendees. After attending, %BMIp95 decreased by 0.087 units/month (P < .001). Eligible nonattendees had an increase of 0.084/month in %BMIp95. Before MEND+ attendance, SBP and DBP increased by 0.041 and 0.022/month, respectively. After MEND+ attendance, SBP and DBP decreased by 0.254/month (P < .001) and 0.114/month (P < .01), respectively. SBP and DBP increased by 0.033 and 0.032/month in eligible nonattendees, respectively. CONCLUSIONS: %BMIp95, SBP, and DBP significantly decreased among MEND+ attendees when implemented in community-based clinical practice settings at DH FQHC. Published by Elsevier Inc.
OBJECTIVE: The Mind, Exercise, Nutrition, Do It! 7-13 (MEND 7-13) program was adapted in 2016 by 5 Denver Health federally qualified health centers (DH FQHC) into MEND+, integrating clinician medical visits into the curriculum and tracking health measures within an electronic health record (EHR). We examined trajectories of body mass index (BMI, kg/m2) percentile, and systolic and diastolic blood pressures (SBP and DBP) among MEND+ attendees in an expanded age range of 4 to 17 years, and comparable nonattendees. METHODS: Data from April 2015 to May 2018 were extracted from DH FQHC EHR for children eligible for MEND+ referral (BMI ≥85th percentile). The sample included 347 MEND+ attendees and 21,061 nonattendees. Mixed-effects models examined average rate of change for BMI percent of the 95th percentile (%BMIp95), SBP and DBP (mm Hg), after completion of the study period. RESULTS: Most children were ages 7 to 13 years, half were male, and most were Hispanic. An average of 4.2 MEND+ clinical sessions were attended. Before MEND+, %BMIp95 increased by 0.247 units/month among MEND+ attendees. After attending, %BMIp95 decreased by 0.087 units/month (P < .001). Eligible nonattendees had an increase of 0.084/month in %BMIp95. Before MEND+ attendance, SBP and DBP increased by 0.041 and 0.022/month, respectively. After MEND+ attendance, SBP and DBP decreased by 0.254/month (P < .001) and 0.114/month (P < .01), respectively. SBP and DBP increased by 0.033 and 0.032/month in eligible nonattendees, respectively. CONCLUSIONS: %BMIp95, SBP, and DBP significantly decreased among MEND+ attendees when implemented in community-based clinical practice settings at DH FQHC. Published by Elsevier Inc.
Entities:
Keywords:
blood pressure; electronic health record; federally qualified health center; pediatric obesity; pediatric weight management intervention
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