The Epidemic in the Room: Childhood Obesity in Florida Safety-Net Health Center Populations

In 1985, Centers for Disease Control data indicated that less than 10% of Floridians were obese (having a Body Mass Index ≥ 30); in 2006, that figure had risen to 24%. Nationally, obesity accounts for more than 300,000 deaths a year and the annual cost to society for obesity is estimated at nearly $100 billion. The CDC estimates that 30% of adult obesity begins in childhood. 

 

Implementing robust health information technology is a way to both measure the real extent of the problem and institute evidenced-based protocols at the point of greatest impact: the exchange between patient, parents, and pediatrician.  CHCA and its member partners are currently seeking the resources required to launch a comprehensive childhood obesity prevention / intervention project. With funding, a physician-driven workgroup within our community health center network will provide electronic and chart-based clinical surveillance of childhood obesity in Florida's safety-net population, monitor current health intervention efforts, and provide a foundation for meaningful, culturally- and geographically-specific best practices in reducing the high cost of obesity in healthcare dollars and years of life lost to the epidemic. 

 

Each pediatrician would be able to select from a set of intervention recommendations with the greatest possibility of success for each individual child and family. After one year, each intervention could be measured against outcomes, patient age, insurance status, demographic characteristics, and more. This would lead to the creation of a Childhood Obesity Practice Manual specific to the safety-net population, allowing for future savings due to reduced long-term effects, and improved quality and length of life for Florida’s most vulnerable populations.

 

Funding is needed to invest in the following resources for this project:

• Programmer and Report Writer time to develop interactive care plans and alerts within electronic health records to prompt nurses and physicians to action
• Development of data tracking reports from EHR
• Engagement of Nurse Informaticist to assist with trending and program development for use of EHR tool
• Medical Director oversight
• Program education sessions and EHR training for specialized components to participating pediatricians
• Program consultation and monitoring from behavioral health specialists

Beyond exam room interactions with patients, the project will also provide data for intervention development, testing and tracking, and eventually form the basis for:

• Development of community partnerships and gathering of resources available for parents and children
• Creation of various Outreach materials targeted at children, families, schools, etc.
• Parent and Community education sessions in various health center communities (includes facility costs, appropriate snacks and beverages) 

At the end of the project period, the comprehensive Childhood Obesity Practice Manual will include clinical guidelines as well as strategies for patient and family compliance, community support, and more. Foundational data will provide the first comprehensive look at the safety-net pediatric population, and serve as an indicator for future health needs and cost projections over the generation.