Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
Telemed J E Health. 2012 Apr;18(3):247-9. doi: 10.1089/tmj.2011.0117. Epub 2012 Feb 22.
Pediatric obesity occurs most frequently in underserved communities where families have difficulty accessing healthcare. Disproportionate obesity rates in rural children denote significant disparities warranting innovative solutions. However, intensive, tertiary-care treatment options outlined in recent expert recommendations may not be available to families living in rural areas. Telemedicine may be useful for providing pediatric obesity treatment to rural families. The aim of this study was to assess the impact of a new outreach program (TeleFIT), which placed telemonitors in four rural satellite clinics to increase access to a pediatric obesity clinic (Brenner Families In Training [FIT]). Before TeleFIT began, of five patients from rural counties enrolled in treatment over a 1-year period, all dropped out by their third visit. Within the first year of TeleFIT, the number of rural patients increased nearly threefold (to 14) and increased again in the second year by an additional 16 new patients (n=35). Preliminary outcomes indicate comparable attrition rates and improvement in weight status compared with patients in conventional treatment. Telemedicine allows rural families to access intensive obesity treatment from local pediatric offices, eliminating geographic barriers. Systems delivering state-of-the-art care in rural areas have tremendous potential for reducing health disparities in rural populations. Further research is needed to test the efficacy of such interventions.
儿科肥胖症最常发生在服务不足的社区，这些社区的家庭难以获得医疗保健。农村儿童不成比例的肥胖率表明存在显著差异，需要创新的解决方案。然而，最近专家建议中概述的密集型、三级护理治疗选择可能无法提供给居住在农村地区的家庭。远程医疗可能有助于为农村家庭提供儿科肥胖症治疗。本研究的目的是评估一项新的外展计划（TeleFIT）的影响，该计划在四个农村卫星诊所放置远程监测器，以增加获得儿科肥胖诊所（Brenner Families In Training [FIT]）的机会。在 TeleFIT 开始之前，在一年的治疗期间，来自农村县的五名患者中，所有人都在第三次就诊时退出。在 TeleFIT 的第一年，农村患者的数量增加了近两倍（增加到 14 人），第二年又增加了 16 名新患者（n=35）。初步结果表明，与接受常规治疗的患者相比，农村患者的退出率和体重状况改善情况相当。远程医疗使农村家庭能够从当地儿科办公室获得密集型肥胖症治疗，消除了地理障碍。在农村地区提供最先进护理的系统具有巨大的潜力，可以减少农村人口的健康差异。需要进一步研究来测试这种干预措施的效果。
