Reed Monique, Cygan Heide, Lui Karen, Mullen Mary
Rush University, Chicago, IL, USA
Rush University, Chicago, IL, USA.
Clin Pediatr (Phila). 2016 Aug;55(9):860-6. doi: 10.1177/0009922815614350. Epub 2015 Nov 18.
Background In the United States, overweight/obesity among youth has reached epidemic proportions. The purpose of this project was to (1) examine primary care provider adherence to American Academy of Pediatrics guidelines; (2) compare adherence based on patients' weight classification, age, race, and gender; and (3) identify areas for improvement in health care delivery. Methods A retrospective chart audit and feedback quality improvement project was conducted with a stratified random sample of 175 charts of 6- to 19-year-olds seen for well-child visits. Frequencies of provider adherence were reported. χ(2) Analyses of weight classification, age, race, or gender influence on adherence was calculated. Results After discussion with the primary care providers, 5 areas were identified as priorities for change (diagnosis based on BMI, parental history of obesity, sleep assessment, endocrine assessment, and attendance of patients at the follow-up visit). Conclusion Cost-efficient, feasible strategies to improve provider adherence to recommendations for identification, prevention and management of childhood overweight and obesity were identified.
在美国,青少年超重/肥胖问题已达到流行程度。本项目的目的是:(1)检查初级保健提供者对美国儿科学会指南的遵守情况;(2)根据患者的体重分类、年龄、种族和性别比较遵守情况;(3)确定医疗保健服务中有待改进的方面。方法:对175份6至19岁儿童健康检查病历进行分层随机抽样,开展回顾性病历审核及反馈质量改进项目。报告了提供者的遵守频率。计算了体重分类、年龄、种族或性别对遵守情况影响的χ(2)分析。结果:与初级保健提供者讨论后,确定了5个优先改变领域(基于BMI的诊断、父母肥胖史、睡眠评估、内分泌评估以及患者随访就诊)。结论:确定了具有成本效益且可行的策略,以提高提供者对儿童超重和肥胖识别、预防及管理建议的遵守情况。