A Tool Kit for Battling Childhood Obesity: Implementing the ABCD Program for Childhood Obesity in Pediatric Primary Care

Abstract

Childhood obesity rates in the United States have tripled in the past three decades. The medical and psychological consequences are numerous and have been shown to track into adulthood. Although the problem is complex, addressing this issue in the primary care setting is a necessary component of pediatric care. Primary care–based weight management programs have been limited because of a lack of provider knowledge and economic and time constraints. One program, the ABCD Weight Management Program, has been designed for use in children ages 6 to 17 years with a body mass index (BMI) greater than the 95th percentile for age and gender. This program builds on the pilot study “Developmental Differences in Adherence to the ABCD Program for Pediatric Weight Measurement” that demonstrated feasibility for use in a primary care setting. Provider guidelines, family educational materials, and intervention protocol were developed for the ABCD Weight Management Program. This program was implemented by two advanced practice nurses as the capstone project for the DNP Program at Robert Morris University. Thirty-five children, ages 6 to 17 years, at two rural/suburban pediatric primary care sites were enrolled from June 2008 through December 2008. The five biweekly intervention sessions provided the child and family with nutritional information, activity instruction, and behavioral modification counseling. Descriptive data including heights, weights, and BMI measurements were obtained at each visit. Retention rates and mean office visit times were also calculated. A paired-samples t test compared the mean of the BMI at visit No. 2 (32.10) with the mean of the BMI at visit No. 5 (31.44), and a significant decrease was found (t (27) = 4.332, P < .001). The ABCD Weight Management Program was successfully implemented in two pediatric primary care sites and is an example of translating evidence into clinical practice. This program has potential for replication in other primary care centers, with a mean office visit time of 29.56 minutes and a retention rate of 80%. All visits were submitted for reimbursement by the child's insurer using appropriate diagnostic coding. This poster describes the ABCD Weight Management Program protocol, educational materials, process for implementation in primary care, and outcome data.