Childhood obesity increases the risk for adverse physical and psychosocial outcomes throughout the lifespan. Intensive behavioral interventions recommended in primary care settings may not conform to current practices, and the most vulnerable populations are often unable to access these services.
Community Health Workers CHWs offer a promising approach to bridging the gap between vulnerable communities and culturally competent services. It is a culturally and linguistically appropriate curriculum, facilitated by CHWs, that targets family behaviors to foster a healthy lifestyle in order to prevent and mitigate childhood overweight and obesity.
Public health and health systems can engage key audiences to share messages about the benefits of childhood obesity prevention efforts and childhood weight management programs. Connect with Nutrition, Physical Activity, and Obesity. To receive email updates about this topic, enter your email address.
Email Address. What's this? The interviews were conducted with individuals, pairs, or groups of participants. The focus of the interviews was the successes and challenges encountered in the implementation of the new Healthy Child Weight Policy and integration of the nutritional counseling into pediatric services. The Project PI also met regularly with the program evaluator to share her perspective on the project status.
Body size was categorized by BMI, calculated as weight in kilograms divided by height in meters squared. In addition, selected demographic data of the children was collected from the EHR. In a month period from September through August , the research team performed a cross-sectional evaluation of 2, unduplicated children ages 2—18 years seen at the WCCHC Pediatric Clinic for Well Visits.
Demographic data are summarized in Table 1. Prevalence of overweight and obesity were very high. Behaviors associated with obesity were common. Obesity-related lifestyle factors, including consumption of large amounts of sugar sweetened beverages and prolonged screen time, were common across all age and BMI groups. Centers for Disease Control and Prevention. Growth Charts. Pediatric services, including nutrition counseling and behavioral health services, were fully integrated. Dieticians now administer many of the Wellness Surveys to parents at Well Visits in brief encounters that increase their visibility, access, and acceptability.
Pediatricians, staff, and parents reported that having the dieticians and psychologists visible and accessible in the pediatric clinic as a key factor in establishing trust and increasing utilization. Counseling on appropriate growth, BMI, nutrition and physical activity is now routinely performed at these examinations and easily documented on the enhanced EHR templates. Ordering of appropriate laboratory tests has been streamlined on the EHR templates and is accomplished more consistently for high-risk patients.
Colored coded growth charts and educational handouts have been well received and utilized by pediatric providers, staff and families. Every child attending a Well Visit, not just the overweight and obese children, is asked about their eating, physical activity, and sleep habits. Prior to this change, talking with children and parents about weight and eating habits was a sensitive topic for pediatric providers, one that was often avoided and because there were fewer resources readily available for patient management.
Dieticians altered their schedules to meet the need of pediatricians and their patients for more support in the afternoons, when older children and adolescents are often seen for Well Visits. The psychologist and the dieticians are now regarded as an integral part of the service team, working side-by-side with the pediatric staff.
This has helped transform the clinic environment to one in which health and wellness is now also a priority for the clinic staff. Healthier foods are now regular options at clinic celebrations and high calories treats are offered less frequently. Providers and staff regularly share their own challenges and successes in weight loss and maintenance of family health with each other and a growing number now participate, as a group representing WCCHC, in community physical activity events such as Fun Runs.
Indeed, these groups have contributed to an ongoing discussion of the results and next steps in community action. The results continue to be used to refine Well Visit services and to develop new ideas for research and health services quality-improvement.
WCCHC, in collaboration with community and academic partners, is actively developing goals, strategies, and new grants proposals on obesity and diabetes prevention both at the health center and in the community. Community health centers are uniquely positioned to address chronic disease health disparities, such as childhood obesity, through the implementation of best practice guidelines complemented by community-based resources, programs and policies that foster disease self-management and prevention.
In this demonstration project, best practice guidelines targeting childhood obesity were implemented using EHR enhancements, a parent survey, pediatric provider and staff training, and a series of cyclical processes to ensure optimal clinic flow, programmatic sustainability, community engagement, cultural appropriateness, and effectiveness. These community health center resources complement pediatric health care provider efforts to promote healthy growth and development, especially in early childhood.
Indeed, the positive influence of pediatric health care providers on parental behavior has been documented in the literature. The data generated by this study document that this health center population of economically disadvantaged, Native Hawaiian, other Pacific Islander and Asian children has a very high prevalence of obesity, beginning from early childhood.
The results of the integrated Wellness Survey, coupled with anthropometric, demographic and diagnostic information collected over time provides a rich, accessible source of data that may be key to achieving the long term goal of reducing the prevalence of obesity and obesity associated morbidity in the community.
Harvard T. The Nutrition Source Menu. Search for:. Future interventions might consider the longer-term impact of such efforts, as observed by Denise Gaudette, an MA-CORD school district project coordinator and middle school health educator: The MA-CORD Project made an impact in our community schools that was evident in the everyday experiences of our students.
Pamela Rivers, the Nursing and Health Services Director in another participating school district, added: As an urban school district and a subset of the local community, it was a most exciting opportunity for the schools to partner with the Harvard Chan School of Public Health, the local community sectors, and the MA-CORD Project. Related Community-wide effort to fight childhood obesity shows promise [Harvard Chan News] Designing effective and sustainable multifaceted interventions for obesity prevention and healthy communities [Commentary by Christina D.
Economos and Ross A. Prevalence of obesity among adults and youth: United States, — NCHS data brief, no
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