Associate Clinical Professor of Pediatrics UCLA Los Angeles, California, United States
Background: Obesity is an Adverse Childhood Experiences (ACE) associated health condition. Mindfulness practices can mitigate the toxic stress response associated with ACEs. The UCLA Fit for Health Clinic (Fit Clinic) is an intensive health behavior and lifestyle program serving pediatric patients with obesity and includes a mindfulness intervention (Fit Mind). Training in mindfulness as a clinical tool is not traditionally taught in pediatric residency. Objective: To increase confidence among pediatric residents in using mindfulness clinically, we developed and evaluated a Fit Mind training for UCLA pediatric residents. Design/Methods: A two-hour virtual training on mindfulness as a clinical tool for obesity was delivered by a Licensed Clinical Social Worker and Fit Clinic pediatrician. Rooted in the self-determination conceptual framework, residents engaged in small group learning activities including journal article review, case-based discussion, sample patient videos, group reflection, and feedback. Learning objectives were jointly developed by Fit Mind providers and UCLA faculty. Residents completed a retrospective pre/post evaluation immediately after the training. They reported satisfaction with the training and confidence to counsel and impact their patients’ lifestyle habits on a 5-point Likert scale. Residents were able to provide feedback on the training via free-text prompts asking what new strategies they plan to implement with patients, as well as what they liked and disliked about the training. Results: The Fit Mind training reached 78/99 pediatric residents across all years of training. Among the 46 (59%) participants who completed the post-training survey, 98% of respondents agreed/strongly agreed that the training met its stated objectives; 89% agreed that the training "provided me with strategies that will benefit my overall health and well-being;” 93% agreed that the training "provided me with strategies that I can apply to my practice.” Residents showed improvements in their confidence to provide counseling to patients with obesity (3.02/5 to 4.02/5, p<.005) and support their patients in making lifestyle changes (3.04/5 to 3.96/5 p<.005). Twenty-seven residents free texted specific strategies they planned to incorporate in their clinical practice, 48% of whom plan to do more counseling around mindful eating.
Conclusion(s): Pediatric residents were satisfied with the training. There was an increase in confidence to provide counseling and self-efficacy in influencing patients’ lifestyle habits after the training. Residents reported they plan to counsel their patients around mindful eating.
