Pediatrics, the journal of the American Academy of Pediatrics, recently published a supplement of articles about childhood obesity’s impact on U.S. children’s hospitals, and these institutions’ efforts to reduce high obesity rates. The eight-article series entitled Pediatric Obesity: Practical Applications and Strategies from Primary to Tertiary Care was written in collaboration with the National Association of Children’s Hospitals and Related Institutions (NACHRI), and clinicians and public health experts at 15 United States children’s hospitals including Seattle Children’s.
The supplement, which appears in the September 2011 issue of Pediatrics, documents applied and observed strategies for combatting obesity, and provides recommendations for reducing pediatric obesity in the United States. Findings from Seattle Children’s experts include:
- Children in weight-management programs are not completing treatment. Opportunities exist to minimize attrition. Despite healthcare providers’ efforts to retain patients in these programs, the majority of participants are not completing the entire course of treatment. Some commonly encountered barriers to patient follow-up include the inability for caregivers to miss work, and transportation difficulties. New programs should assess and address patient/family-related barriers during program development and subsequently institute quality-improvement measures to minimize attrition and improve outcomes.
- Comprehensive and frequent in-person training by obesity experts enhance primary care providers’ ability to identify pediatric obesity and refer patients to weight-management programs. Internet-based interactive training and phone interactions should be viewed as less effective.
- New funding revenues for weight-management initiatives must be found to ensure program sustainability. Insurance coverage frequently fails to adequately reimburse the multiple providers and multiple visits required for comprehensive, multi-disciplinary obesity care. Pediatric weight-management programs are destined for financial failure unless other sources of revenue are made available.
- U.S. children’s hospital administrators view tackling childhood obesity as integral to their mission to care for children. Nearly three-quarters of survey respondents reported that their obesity programs were integrated into their hospital’s strategic plans. A key reason obesity programs add to children’s hospitals’ missions is because they help prevent future health problems in children. Lack of insurance reimbursement and high-operating costs were the most frequently cited challenges to program success.
“Obesity is a health problem that affects 15% of children and teens in the United States. Today there are three times as many obese youth as there were 20 years ago,” said Lenna Liu, MD, MPH, and physician lead of Seattle Children’s Obesity Program. “Our collaboration with the nation’s top obesity prevention leaders will help us find the best approaches for preventing and managing childhood obesity. Our goal is to ultimately reduce the occurrence of the health conditions that can come with being overweight – like asthma, high blood pressure, diabetes and heart disease.”
The 15 hospitals that collaborated on the supplement also make up NACHRI’s childhood obesity workgroup, Focus on a Fitter Future. The hospitals in the group include Arkansas Children’s Hospital, Children’s Hospital Los Angeles, Mattel Children’s Hospital UCLA, Children’s Hospital Colorado, Alfred I. DuPont Hospital for Children, Mt. Washington Pediatric Center, Helen DeVos Children’s Hospital, Children’s Mercy Hospital and Clinics, Duke Children’s Hospital and Health Center, Nationwide Children’s Hospital, Doernbecher Children’s Hospital, Children’s Medical Center Dallas, University of Virginia Children’s Hospital, Seattle Children’s and Children’s Hospital of Wisconsin.
Seattle Children’s collaborators include Dr. Liu; Heather Paves, MS, RD, CD; and Maureen Pomietto, MN, RN.
The Pediatrics supplement, Pediatric Obesity: Practical Applications and Strategies from Primary to Tertiary Care, is available online at: http://pediatrics.aappublications.org/content/128/Supplement_2.toc.
About Seattle Children’s Obesity Program
The Seattle Children’s Obesity Program is a multidisciplinary group of health-care professionals that works to increase awareness, provide education and resources and act to decrease childhood obesity. It is dedicated to the development of culturally responsive and age-appropriate resources for families and providers.
About Seattle Children’s Hospital
Consistently ranked as one of the best children’s hospitals in the country by U.S. News & World Report, Children’s serves as the pediatric and adolescent academic medical referral center for the largest landmass of any children’s hospital in the country (Washington, Alaska, Montana and Idaho). For more than 100 years, Children’s has been delivering superior patient care and advancing new treatments through pediatric research. Children’s serves as the primary teaching, clinical and research site for the Department of Pediatrics at the University of Washington School of Medicine. The hospital works in partnership with Seattle Children’s Research Institute and Seattle Children’s Hospital Foundation. Together they are Seattle Children’s, known for setting new standards in superior patient care for more than 100 years. For more information visit http://www.seattlechildrens.org.