Abstract P088: Assessing the Use of a Preventive Cardiology Lifestyle Screening (PCLS) Tool in a Pediatric Sub-Specialty Lipid Clinic

Abstract

Objective: Lifestyle modification is recommended to improve cholesterol levels in the pediatric population with the goal of reducing CVD risk. Existing tools assessing pediatric lifestyle habits are cumbersome and lack specificity. We developed the Preventive Cardiology Lifestyle Screen (PCLS) to assess behaviors relevant to CVD risk, and evaluated its use in a subspecialty lipid clinic at a large pediatric teaching hospital. Methods: Eligible participants were 2-21 years old, English speaking and presenting for care in a pediatric lipid clinic. We evaluated test-retest agreement using weighted kappa statistics, and validity of PCLS compared to longer research questionnaires [Block Food and Activity Questionnaires and Rapid Eating Assessment for Patients (REAP)] using Spearman correlation coefficients. Results: Participants (n = 138) had a mean age of 13 years; 50% were female, 22% reported a household income <$50,000. Median non-HDL cholesterol was 149.2 mg/dL and HDL cholesterol was 48 mg/dL. Of participants 2-17 years old (n=122), 15% were overweight and 46% were obese. Test re-test agreement for those ≥10 years (n=24) was good (weighted kappa >.75) for fruits and vegetables (0.83, 0.82 respectively), chicken no skin (0.89), processed meats (0.78) and sports drinks (.75). Test-retest agreement was poor (weighted kappa <.50) for regular soda intake (0.40), regular fat dairy (0.47), and eating lunch (0.45). Activity (sports 0.94 gym class 0.77) and inactivity (weekend video games 0.88 hours of sleep 0.78) overall had high test-retest agreement for most questions. Examining across dietary domains, the PCLS performed well at baseline compared to the BLOCK and REAP surveys in the domains of saturated fat, glycemic index, sodium and fiber (Table 1). Conclusion: The PCLS performed well on test re-test agreement, and responses correlated with previously validated research tools in most domains. This tool shows promise for use in the care of children with CVD lipid disorders.