California State University, Sacramento, Sacramento, CA, USA.
University of California, Merced, CA, USA.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211009695. doi: 10.1177/21501327211009695.
Within a medical clinic environment, pediatric obesity prevention education for families faces challenges. Existing long-term government-funded nutrition education programs have the expertise and staff to deliver. The purpose is to determine feasibility of colocating the Expanded Food and Nutrition Education Program (EFNEP) into a medical clinic setting to support pediatric obesity prevention.
Physicians from a large university teaching and research hospital (n = 73) and 4 small Medicaid-serving community clinics (n = 18) in the same geographic area in northern California were recruited and trained in the patient-referral protocol for a primary prevention intervention provided by EFNEP. The 8-week intervention deployed in the medical clinics, included general nutrition, physical activity and parenting topics anchored with guided goal setting and motivational modeling. Referral, enrollment, and attendance data were collected for 2 years. Parent and physician feasibility surveys, parent interviews and parent risk assessment tools were administered. Paired-sample t-test analysis was conducted.
Twenty intervention series with parents of patients (n = 106) were conducted at 5 clinics. Physicians (n = 92) generated 686 referrals. Every 6 referrals generated 1 enrolled parent. Physicians (91%, n = 34) reported the intervention as useful to families. Parents (n = 82) reported improved child behaviors for sleep, screen time, physical activity, and food and beverage offerings ( < .0001) and at family mealtime ( < .001). Focus group interviews (n = 26) with 65 participants indicated that parents (97%) reacted positively to participating in the intervention with about a third indicating the classes were relevant to their needs.
The intervention is a feasible strategy for the 5 medical clinics. Physicians referred and parents enrolled in the intervention with both physicians and parents indicating positive benefits. Feasibility is contingent upon physician awareness of the intervention and motivation to refer patients and additional EFNEP and clinic staff time to enroll and keep parents engaged.
在医疗诊所环境中，面向家庭的儿科肥胖预防教育面临挑战。现有的长期政府资助的营养教育计划拥有提供教育的专业知识和人员。本研究旨在确定将扩大食品与营养教育计划（EFNEP）纳入医疗诊所环境以支持儿科肥胖预防的可行性。
从加利福尼亚州北部同一地理位置的一所大型大学教学和研究医院（n=73）和 4 家小型医疗补助服务社区诊所（n=18）招募医生，并对他们进行 EFNEP 提供的初级预防干预措施的患者转介方案进行培训。在医疗诊所中实施的为期 8 周的干预措施包括一般营养、身体活动和育儿主题，以指导目标设定和动机建模为基础。收集了 2 年的转介、入组和出席数据。对父母和医生进行可行性调查，对父母进行访谈，并使用父母风险评估工具进行评估。进行了配对样本 t 检验分析。
在 5 家诊所中，共开展了 20 个针对患者父母的干预系列（n=106）。医生（n=92）转介了 686 名患者。每转介 6 名患者，就有 1 名患者入组。医生（91%，n=34）报告称该干预措施对家庭有用。父母（n=82）报告称，他们的孩子在睡眠、屏幕时间、身体活动、食物和饮料供应方面的行为得到了改善（ < .0001），在家庭用餐时间也得到了改善（ < .001）。对 26 名参与父母（n=65）的焦点小组访谈表明，父母（97%）对参与该干预措施反应积极，约三分之一的父母表示课程与他们的需求相关。
该干预措施对于 5 家医疗诊所来说是一种可行的策略。医生转介，父母入组，医生和父母均表示有益。可行性取决于医生对干预措施的认识以及转介患者的积极性，以及需要额外的 EFNEP 和诊所工作人员时间来招募并让父母参与进来。
