Imoisili Omoye E, Lundeen Elizabeth A, Freedman David S, Womack Lindsay S, Wallace Jessica, Hambidge Simon J, Federico Steven, Everhart Rachel, Harr Delia, Vance Jillian, Kompaniyets Lyudmyla, Dooyema Carrie, Park Sohyun, Blanck Heidi M, Goodman Alyson B
Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity (OE Imoisili, EA Lundeen, DS Freedman, L Kompaniyets, C Dooyema, S Park, HM Blanck, and AB Goodman), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga; Epidemic Intelligence Service (OE Imoisili and LS Womack), Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Ga; United States Public Health Service (OE Imoisili, LS Womack, HM Blanck, and AB Goodman), Rockville, Md.
Obesity Prevention and Control Branch, Division of Nutrition, Physical Activity, and Obesity (OE Imoisili, EA Lundeen, DS Freedman, L Kompaniyets, C Dooyema, S Park, HM Blanck, and AB Goodman), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga.
Acad Pediatr. 2021 Mar;21(2):312-320. doi: 10.1016/j.acap.2020.11.026. Epub 2020 Dec 3.
The Mind, Exercise, Nutrition, Do It! 7-13 (MEND 7-13) program was adapted in 2016 by 5 Denver Health federally qualified health centers (DH FQHC) into MEND+, integrating clinician medical visits into the curriculum and tracking health measures within an electronic health record (EHR). We examined trajectories of body mass index (BMI, kg/m) percentile, and systolic and diastolic blood pressures (SBP and DBP) among MEND+ attendees in an expanded age range of 4 to 17 years, and comparable nonattendees.
Data from April 2015 to May 2018 were extracted from DH FQHC EHR for children eligible for MEND+ referral (BMI ≥85th percentile). The sample included 347 MEND+ attendees and 21,061 nonattendees. Mixed-effects models examined average rate of change for BMI percent of the 95th percentile (%BMIp95), SBP and DBP (mm Hg), after completion of the study period.
Most children were ages 7 to 13 years, half were male, and most were Hispanic. An average of 4.2 MEND+ clinical sessions were attended. Before MEND+, %BMIp95 increased by 0.247 units/month among MEND+ attendees. After attending, %BMIp95 decreased by 0.087 units/month (P < .001). Eligible nonattendees had an increase of 0.084/month in %BMIp95. Before MEND+ attendance, SBP and DBP increased by 0.041 and 0.022/month, respectively. After MEND+ attendance, SBP and DBP decreased by 0.254/month (P < .001) and 0.114/month (P < .01), respectively. SBP and DBP increased by 0.033 and 0.032/month in eligible nonattendees, respectively.
%BMIp95, SBP, and DBP significantly decreased among MEND+ attendees when implemented in community-based clinical practice settings at DH FQHC.
“心智、锻炼、营养，行动起来！7 - 13”（MEND 7 - 13）项目于2016年由丹佛健康系统的5家联邦合格健康中心（DH FQHC）改编为MEND+，将临床医生的诊疗纳入课程，并在电子健康记录（EHR）中跟踪健康指标。我们研究了年龄范围扩大至4至17岁的MEND+参与者以及可比的非参与者的体重指数（BMI，kg/m²）百分位数、收缩压和舒张压（SBP和DBP）的变化轨迹。
从2015年4月至2018年5月期间DH FQHC的EHR中提取符合MEND+转诊条件（BMI≥第85百分位数）儿童的数据。样本包括347名MEND+参与者和21061名非参与者。混合效应模型研究了研究期结束后BMI第95百分位数（%BMIp95）、SBP和DBP（mmHg）的平均变化率。
大多数儿童年龄在7至13岁之间，一半为男性，大多数为西班牙裔。平均参加了4.2次MEND+临床课程。在参加MEND+之前，MEND+参与者的%BMIp95每月增加0.247个单位。参加之后，%BMIp95每月下降0.087个单位（P <.001）。符合条件的非参与者的%BMIp95每月增加0.084。在参加MEND+之前，SBP和DBP分别每月增加0.041和0.022。参加MEND+之后，SBP和DBP分别每月下降0.254（P <.001）和0.114（P <.01）。符合条件的非参与者的SBP和DBP分别每月增加0.033和0.032。
在DH FQHC的社区临床实践环境中实施时，MEND+参与者的%BMIp95、SBP和DBP显著下降。
