Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado (Dr Daley, Mss Barrow and Reifler, and Mr Tabano); Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado (Dr Daley); Denver Public Health Department, Denver Health, Denver, Colorado (Drs Kraus and Davidson); Children's Hospital Colorado, Aurora, Colorado (Ms Davies); Colorado Department of Public Health and Environment, Denver, Colorado (Messrs Williford and White); and Tri-County Health Department, Greenwood Village, Colorado (Dr Shupe).
J Public Health Manag Pract. 2020 Jul/Aug;26(4):E1-E10. doi: 10.1097/PHH.0000000000000942.
Although local childhood obesity prevalence estimates would be valuable for planning and evaluating obesity prevention efforts in communities, these data are often unavailable.
The primary objective was to create a multi-institutional system for sharing electronic health record (EHR) data to produce childhood obesity prevalence estimates at the census tract level. A secondary objective was to adjust obesity prevalence estimates to population demographic characteristics.
DESIGN/SETTING/PARTICIPANTS: The study was set in Denver County, Colorado. Six regional health care organizations shared EHR-derived data from 2014 to 2016 with the state health department for children and adolescents 2 to 17 years of age. The most recent height and weight measured during routine care were used to calculate body mass index (BMI); obesity was defined as BMI of 95th percentile or more for age and sex. Census tract location was determined using residence address. Race/ethnicity was imputed when missing, and obesity prevalence estimates were adjusted by sex, age group, and race/ethnicity.
MAIN OUTCOME MEASURE(S): Adjusted obesity prevalence estimates, overall, by demographic characteristics and by census tract.
BMI measurements were available for 89 264 children and adolescents in Denver County, representing 73.9% of the population estimate from census data. Race/ethnicity was missing for 4.6%. The county-level adjusted childhood obesity prevalence estimate was 13.9% (95% confidence interval, 13.6-14.1). Adjusted obesity prevalence was higher among males, those 12 to 17 years of age, and those of Hispanic race/ethnicity. Adjusted obesity prevalence varied by census tract (range, 0.4%-24.7%). Twelve census tracts had an adjusted obesity prevalence of 20% or more, with several contiguous census tracts with higher childhood obesity occurring in western areas of the city.
It was feasible to use a system of multi-institutional sharing of EHR data to produce local childhood obesity prevalence estimates. Such a system may provide useful information for communities when implementing obesity prevention programs.
尽管社区层面的儿童肥胖流行率估计值对于规划和评估肥胖预防工作非常有价值，但这些数据往往无法获得。
主要目标是创建一个多机构系统，以共享电子健康记录（EHR）数据，从而在普查区层面生成儿童肥胖流行率估计值。次要目标是根据人口人口统计学特征调整肥胖流行率估计值。
设计/设置/参与者：该研究在科罗拉多州丹佛县进行。六家地区性医疗保健组织在 2014 年至 2016 年期间与州卫生部门共享了 EHR 衍生数据，用于 2 至 17 岁的儿童和青少年。使用常规护理期间测量的最新身高和体重来计算体重指数（BMI）；肥胖定义为 BMI 达到年龄和性别对应的第 95 百分位数或更高。普查区位置使用居住地址确定。当缺失种族/民族信息时，采用推断法，并根据性别、年龄组和种族/民族调整肥胖流行率估计值。
总体上和按人口统计学特征以及按普查区划分的调整后肥胖流行率估计值。
丹佛县有 89264 名儿童和青少年的 BMI 测量值可用，占人口普查数据中人口估计值的 73.9%。种族/民族信息缺失 4.6%。该县调整后的儿童肥胖流行率估计值为 13.9%（95%置信区间，13.6-14.1）。调整后的肥胖流行率在男性、12 至 17 岁的人群以及西班牙裔中更高。调整后的肥胖流行率因普查区而异（范围为 0.4%-24.7%）。有 12 个普查区的调整后肥胖流行率为 20%或更高，该市西部的几个相邻普查区的儿童肥胖率更高。
使用多机构共享 EHR 数据的系统来生成当地儿童肥胖流行率估计值是可行的。在实施肥胖预防计划时，此类系统可能为社区提供有用的信息。
