PROGRAMS: Optimizing Healthcare

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Conducting a comprehensive evidence review

The American Academy of Pediatrics' Institute for Healthy Childhood Weight with the support of the Center for Disease Control and Prevention, is conducting a systematic review of literature on pediatric obesity as a critical first step in advancing pediatric obesity care in hopes of an eventual publication of Clinical Practice Guideline focused on pediatric obesity. [In progress] 

Investigating a pragmatic family-centered approach to childhood obesity treatment

The Institute is partnering on a family-centered 5-year research study focused on childhood obesity treatment. This project is led by the Washington University School of Medicine in St. Louis and is funded by the Patient-Centered Outcomes Research Institute (PCORI), an independent, nonprofit organization authorized by Congress under the Affordable Care Act. [In progress]

Improving healthy weight assessment during health supervision visits

Health professionals who provide direct services to infants, children and adolescents, as well as their families, play a critical role in the implementation of the Bright Futures Guidelines. The Institute is partnering on the Bright Futures implementation project by supporting training and implementation tools on best practices for effective weight assessment and counseling for nutrition and physical activity for children from birth to 21 years. [In progress]

Exploring community-clinic linkages to support delivery of weight management services

The Healthy Weight and Your Child Collaborative project in collaboration with the Y USA focused on strengthening the coordination between local Y's offering the Healthy Weight and You Child Program and nearby pediatric practices and to improve quality of services being offered through improved training and care coordination. The key outcomes for this project include improving: patient assessment and referral, patient retention and engagement, program completion, and follow-up and medical management as needed as well as increased trust and strong partnerships between local healthcare providers and Y staff. [Completed] Program Overview

Improving obesity assessment and identification in primary care

The Childhood Obesity in Primary Care Quality Improvement (COPC) Project is a 19-week virtual quality improvement program. Participants receive 25 Part IV MOC credits. To date three rounds of the COPC project have been conducted with over 50 practices across 20 states. An overwhelming number of practice sites show improvements after participation in this project. If you are interested in joining the next iteration of COPC please email obesity@aap.org. [Round 4 in Progress]

IMPACT: Data from the project shows that 90% of the participating practices indicate they made drastic or moderate improvements and all practices showed improvements in the project measures over the project period. Our sustainability research also indicates that the majority of practices maintained their improvements [to see results, click here]. 

Identifying pediatrician's views and practices related to childhood obesity

 

The Institute in partnership with our own Academy's Department of Research and our colleagues as the Centers for Disease Control and Prevention, conducted the Periodic Survey of Fellows 96 titled "Pediatricians' views and practices related to childhood overweight and obesity" in 2017. Findings were presented at poster sessions at the Pediatric Academic Society and the Academy's National Conference and Exhibition. Numerous articles are under development. The Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention provided research support (Grant # U38OT000167).  [Publications in process]

IMPACT: Data from this survey will inform future education, implementation and quality improvement efforts. Please review our series of posters highlighting key findings here.
Supporting healthcare providers in delivery of anticipatory guidance around early feeding & nutrition

 

As part of the Building a Foundation for Healthy Active Living project, the Institute for Healthy Childhood Weight has created a portfolio of resources for clinicians to support their anticipatory guidance around healthy active living. The resources include: Series of online CME and MOC Part 2 modules to help providers improve delivery of key content during the first eleven well visits and a suite of family engagement resources (videos, infographics, and social media graphics to help create awareness and engage families in the importance of sound nutrition and healthy behaviors from the start (in English and Spanish). To access the resources, click here. Funding for this project was made possible by grants from the Centers for Disease Control and Prevention. [Project completed in 2018]

IMPACT: In the first few months of the launch of these materials the family education materials have had over 100,000 impressions on social media, the videos were viewed almost 10,000 times, and over 5000 copies of the infographics were distributed to primary care providers.
  Improving multidisciplinary approaches in obesity in primary care
The American Academy of Pediatrics Institute for Healthy Childhood Weight, the Academy of Nutrition and Dietetics, and the Alliance for a Healthier Generation partnered to conduct the Childhood Obesity Performance Improvement Project (COPI) Collaborative. COPI was a 12-month, practice-level, quality improvement collaborative to improve practice systems for youth, ages 3-17, with overweight or obesity. Aims focused on aligning practice systems with the evidence base, improving care coordination between pediatric practices and RDs, and facilitating use of the Healthier Generation Benefit (HGB). The HGB insurance benefit guaranteed annual coverage for at least four follow-up weight management visits each with a primary care provider and an RD. [Project completed in 2016]
IMPACT: Evaluation results linked participation in COPI with improvements in various aspects of evidence-informed care, practice/RD collaboration, and utilization of the HGB/insurance, although some persistent insurance barriers were common. Participants also reported an increased level of knowledge regarding general processes for improving care. 
Improving access and systems of care for evidence-based obesity treatment in pediatrics
On July 9–10, 2015, the American Academy of Pediatrics (AAP) Institute for Healthy Childhood Weight, the Pediatric Obesity Section of The Obesity Society, and members of the Institute of Medicine's Innovation Collaborative on Integrated Clinical and Social Systems for the Prevention and Treatment of Obesity hosted 43 multidisciplinary, cross‐sector stakeholders (clinicians, scientists, policy makers, representatives from advocacy organizations, and insurance industry leaders), plus a patient advocate and her parent, at a meeting to: 1 develop feasible, acceptable, effective, and sustainable care delivery models supporting USPSTF recommendations and 2 create a unified strategy for policy change regarding reimbursement. Learn more about conference findings by clicking here. This conference was supported by R13HS02281601: "Evidence‐based childhood obesity treatment: Improving access and systems of care" from the Agency for Healthcare Research and Quality. Funding amount was matched by American Academy of Pediatrics—Institute for Healthy Childhood Weight. [Project completed in 2016]
IMPACT: The conference culminated in an article, named one of the top ten articles of 2017 by Obesity, that identified key components of effective obesity care and explored payment models. This conference also formed the foundation of the 2018 funded pragmatic research study mentioned above. 
Training healthcare providers in Motivational Interviewing techniques
In partnership with Kognito, leaders in virtual learning experiences that drive positive change in health behaviors, the Institute has created a mobile app, Change Talk: Childhood ObesityTM, that allows a healthcare provider to engage in a series of practice conversations with virtual parents and their children. Through the conversations, you learn to apply Motivational Interviewing techniques through a series of scenarios framed around the topics of sugary drinks, breastfeeding, and picky eating. Development of this app was made possible by a grant from Danone Early Life Nutrition. The Institute gratefully acknowledges the shared commitment and support of its Founding Sponsor, Nestlé. [Project completed in 2016]
IMPACT: This award-winning app has over 60,000 downloads! This app makes learning and practicing MI skills attainable for the busy clinician without the expense of in-person trainings, travel and time out of the office. Click here to learn more about using virtual reality to train clinicians.
Supporting healthcare providers in delivering anticipatory guidance about early obesity prevention
Through the Healthy Active Living for Families (HALF) project resources were designed that support the implementation of early obesity prevention (infancy through age 5) at the point of primary care by leveraging parent focus groups and the latest evidence. Resources include an implementation guide, an app, and web-based patient engagement tools for providers websites.  This project was funded by a grant from Nestlé Nutrition Institute. [Project completed in 2012] 
IMPACT: This flagship project filled a critical gap in knowledge and resources around early obesity prevention and has been instrumental in supporting providers with tools necessary to improve their early obesity prevention. Learn more here (poster 1 and poster 2). See executive summary of parent research and descriptions of related tools.