PGY-1 Resident Physician Rady Children's Hospital San Diego San diego, California, United States
Background: The prevalence of childhood obesity has increased over the last 30 years, leading to earlier onset of obesity-related comorbidities. The American Academy of Pediatrics (AAP) released Clinical Practice Guidelines for the Evaluation and Treatment of Pediatric Obesity in January 2023. These guidelines suggest that Intensive Health Behavior and Lifestyle Treatment, which includes 26 or more hours of face-to-face, family-based counseling over a 3- to 12-month period, is the most consistently effective way to manage pediatric obesity. Objective: The purpose of this study was to implement and evaluate a standardized protocol for the management of pediatric obesity in a low-resource primary care setting in accordance with the recent AAP guidelines. Design/Methods: This prospective pilot study was approved by the Institutional Review Board. The study enrolled patients aged 2-17 with a Body Mass Index (BMI) ≥85th percentile. At enrollment, each patient received an educational binder that included information on nutrition and exercise recommendations specific to the participant's age group. With the help of the treating physician, the patient and family set one healthy lifestyle goal. BMI and blood pressure were obtained; labs were ordered per AAP guidelines. A Center for Disease Control BMI-for-age growth curve with the patient’s BMI plotted was given and explained to the patient’s caregiver and/or patient. Follow-up visits were scheduled every 2 weeks for 12 total visits, which are currently ongoing and are expected to be completed by March 2024. At each follow up visit, BMI and blood pressure are obtained. Patients receive an additional educational handout, a new lifestyle goal is created, and the growth curve is updated. On visits 2, 6, and 12, patients and caregivers complete surveys regarding perception of the study and barriers to success. Results related to follow-up adherence, BMI, blood pressure, lab results and surveys are recorded in REDCap. Data analysis will be performed using R Version 4.0.4 once follow-up visits for currently enrolled patients are complete.
