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18404

Clinician Adherence to Obesity Guidelines In School-Based Health Centers

Saturday, October 20, 2012: 8:50 AM
Room 270 (Morial Convention Center)
Danielle Dandreaux, PhD1, Bonnie Gance-Cleveland, PhD, FAAN2, Laura Szalacha, PhD3, Lisa Militello, MSN, MPH, CPNP2, Lynn Gilbert, RN, PhD, PNP-C4, Jinnette Senecal5, Gabriel Shaibi, PhD, PT2, Keri Bolton Oetzel, PhD6, Diane Skiba, PhD, FAAN4, Kevin Gilbert, PhD7 and Natalie Russell7, (1)College of Nursing and Health Innovations, Arizona State University, Phoenix, AZ, (2)College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, (3)College of Nursing, The Ohio State University, Columbus, OH, (4)College of Nursing, University of Colorado Denver, Aurora, CO, (5)Health Solutions/Educational Support Services, Arizona State University, Phoenix, AZ, (6)Waikato Management School, The University of Waikato, Raglan, AZ, New Zealand, (7)Clinical Decision Support for Obesity, HeartSmartKids LLC, Boulder, CO

Objectives

Obesity in children has risen over the past four decades, especially among ethnic minority populations. This AHRQ funded study is a comparative effectiveness trial of web-based training on the current recommendations for prevention and treatment of childhood obesity with and without technology decision support.  The purpose of this presentation is to describe the providers of 24 school based health centers and the children that they serve.  Provider’s adherence to the current guidelines related to childhood overweight and obesity will also be discussed.

Methods

Baseline data including provider surveys and chart audits will be presented. Providers from 24 school based health centers have been consented and data has been collected from 23 centers. Thirty providers completed the provider survey and 786 chart audits were completed at 23 centers.

Results

Thirty providers were equally distributed across 6 states. The majority of providers were female (96.6%) and Non-Hispanic White (70.0%). Providers had a mean age of 44.97 (SD= 10.08). Over half of the providers reported that they were bilingual (70%). Chart audits were completed on children aged 5 – 12 who presented at the school based health center for a well child or sports physical visit. Centers serve a diverse population (Hispanic 42.4%, Non-Hispanic White 30.9%, Non-Hispanic Black 13.4%, Mixed/Other 4.8%, Asian .8% and Native American .5%). Most (73.4%) reportedly had insurance. Children were almost half female (49.6%) and had a mean age of 9.21 (SD = 2.30). Provider’s recorded BMI 96% of the time (SD=20.00) and BMI percentage 84% of the time (SD=37.41). Provider’s recorded blood pressure less frequently (72%; SD=45.83) and rarely recorded blood pressure percentile (24%; SD=43.59). Provider’s diagnosed 93 children (11.8%) as overweight and 110 (14.0%) as obese. However, based on provider’s report of child’s BMI percentage 201 children should have received a diagnosis of overweight but only 46 (22.9%) received an overweight diagnosis and 166 children should have received a diagnosis of obesity whereas 99 (59.6%) children received an obesity diagnosis. 

Conclusions

School based health centers serve at risk youth and the baseline data suggests that providers are not currently following the guidelines, thus missing the opportunities to address childhood obesity during well child visits.