Technology to Promote Evidence-Based Obesity Care

Wednesday, 1 August 2012: 3:30 PM

Bonnie Gance-Cleveland, PhD, RNC1
Lynn Gilbert, PhD, CPNP2
Kevin Gilbert, PhD3
Jinnette Senecal, MEd, BS, BA4
Keri Bolton Oetzel, PhD, MPH5
Diane J. Skiba, PhD6
Gabriel Shaibi, PhD, PT4
(1)College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ
(2)College of Nursing, University of Colorado Denver, Aurora, CO
(3)Clinical Decision Support for Obesity, HeartSmartKids LLC, Boulder, CO
(4)College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ
(5)Waikato Management School, University of Waikato, Raglan, New Zealand
(6)College of Nursing, University of Colorado Denver, Aurora Centennial, CO


Obesity in children has risen over the past four decades, especially among ethnic minority populations. The purpose of this AHRQ funded study is to compare web-based training on childhood obesity guidelines with and without technology decision support on the implementation of guidelines into practice. This presentation includes a description of the training and technology support for the implementation of guidelines. The health disparities collaborative and chronic care models are guiding frameworks for the study. 


Baseline data including provider surveys, chart audits, and patient satisfaction surveys will be presented. Providers from 24 SBHCs have been consented and data collected at 20 centers.


Centers serve a diverse population (White 41%, Hispanic 31%, Black 13%, Native American 0.6%, Asian 0.8%, Mixed/Other 4.5%). Over half (70%) reported having insurance and 45.8% were on free and reduced lunch. Chart audits on 503 charts indicated that 24% were obese, 17% were overweight, 57% were normal weight, and 2% were underweight; however, there were a significant number (p < .000) without an accurate diagnosis of overweight or obesity. There were no differences in overweight/obesity by ethnic group (p= .453), however, there were differences by gender and age (p.= 037). Overall, satisfaction with care was good; however, there were significant differences by state in exceptional care categories. Clinician satisfaction with web-based training has been very positive (100% agree or strongly agree). 


SBHCs serve at risk youth and the baseline data suggest the providers are not currently following the guidelines thus missing opportunities to address childhood obesity during well child visits. Web-based instruction is an economical and efficient method of disseminating guidelines to multiple and geographically separated sites and has the potential to improve the implementation of guidelines to these diverse populations. Computer technology can facilitate provider integration of current evidence into practice.