Challenges and solutions to sustaining paediatric weight management programs in the United States.

Paediatric weight management (PWM) programs in the United States (US) face challenges in providing sustainable multidisciplinary care for patients. The aim of this study was to report PWM program approaches to sustaining program delivery. A survey of 39 PWM programs was administered to identify challenges and solutions to program sustainability.

Characteristics of paediatric weight management in the United States: Associations with program retention and BMI outcomes in the paediatric obesity weight evaluation registry (POWER).

Objective: To describe characteristics of paediatric weight management (PWM) programs across the United States and evaluate associations with program-specific retention rates and body mass index (BMI) outcomes at 6 months.

Methods: A program profile survey was administered to 33 programs within the Paediatric Obesity Weight Evaluation Registry (POWER) to assess program staffing, services, and treatment format. Patient retention and percent of the 95th BMI percentile (%BMIp95) changes were assessed for each program.

Trends in prescribing anti-obesity pharmacotherapy for paediatric weight management: Data from the POWER Work Group.

Introduction: To better inform the field of obesity medicine, we set out to describe the current use of pharmacotherapy meant to improve patient weight status among a group of clinicians connected through the Paediatric Obesity Weight Evaluation Registry (POWER), as well as reasons behind clinicians' use or non-use of the medications.

Methods: Paediatric weight management (PWM) programs participating in POWER were asked to complete a program profile survey in 2014 (n = 30) and 2017 (n = 33); questions about pharmacotherapy use were included. Descriptive statistics were used to identify: (a) the proportion of PWM programs offering obesity pharmacotherapy; (b) the medications most commonly prescribed; and (c) reasons among non-prescribers for not offering pharmacotherapy.

Electronic Gaming Characteristics Associated with Class 3 Severe Obesity in Youth Who Attend the Pediatric Weight Management Programs of the COMPASS Network.

Background: The prevalence of severe obesity and electronic game use among youth has increased over time.

Methods: We administered a survey assessing gaming and psycho-demographic characteristics to youth aged 11-17 attending five weight management programs. We conducted chi-square and logistic regression analyses to describe the association between class 3 severe obesity and gaming characteristics.

Community Healthcare and Technology to Enhance Communication in Pediatric Obesity Care.

Childhood obesity continues to be a critical healthcare issue and a paradigm of a pervasive chronic disease affecting even our youngest children. When considered within the context of the socioecological model, the factors that influence weight status, including the social determinants of health, limit the impact of multidisciplinary care that occurs solely within the medical setting. Coordinated care that incorporates communication between the healthcare and community sectors is necessary to more effectively prevent and treat obesity.

Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics.

Background And Objectives: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics.

Methods: Staff and providers in 8 resident clinics participated in a 12-month QI study.

A Learning Collaborative Model to Improve Human Papillomavirus Vaccination Rates in Primary Care.

Objective: Human papillomavirus (HPV) vaccination rates remain low, in part because of missed opportunities (MOs) for vaccination. We used a learning collaborative quality improvement (QI) model to assess the effect of a multicomponent intervention on reducing MOs.

Methods: Study design: pre-post using a QI intervention in 33 community practices and 14 pediatric continuity clinics over 9 months to reduce MOs for HPV vaccination at all visit types.

Calculating a Continuous Metabolic Syndrome Score Using Nationally Representative Reference Values.

Objective: The prevalence of metabolic syndrome in youth varies on the basis of the classification system used, prompting implementation of continuous scores; however, the use of these scores is limited to the sample from which they were derived. We sought to describe the derivation of the continuous metabolic syndrome score using nationally representative reference values in a sample of obese adolescents and a national sample obtained from National Health and Nutrition Examination Survey (NHANES) 2011-2012.

Methods: Clinical data were collected from 50 adolescents seeking obesity treatment at a stage 3 weight management center.

Problem Video Gaming Among Children Enrolled in Tertiary Weight Management Programs.

Prior studies show seven percent to nine percent of children demonstrate gaming behaviors that affect a child's ability to function (e.g., problem gaming), but none have examined the association between problem gaming and weight status.

The Association Between Measures of Fitness and Metabolic Health in Treatment-Seeking Youth with Obesity.

Background: Both cardiorespiratory fitness (CRF) and measures of muscular fitness are associated with metabolic syndrome in adults. However, limited information exists about these relationships in youth with severe obesity who are at increased risk of metabolic dysfunction. The purpose of this study was to examine the relationship between fitness and metabolic health in treatment-seeking youth with obesity.

Establishment of the Pediatric Obesity Weight Evaluation Registry: A National Research Collaborative for Identifying the Optimal Assessment and Treatment of Pediatric Obesity.

Background: Prospective patient registries have been successfully utilized in several disease states with a goal of improving treatment approaches through multi-institutional collaboration. The prevalence of youth with severe obesity is at a historic high in the United States, yet evidence to guide effective weight management is limited. The Pediatric Obesity Weight Evaluation Registry (POWER) was established in 2013 to identify and promote effective intervention strategies for pediatric obesity.

Characteristics of Youth Presenting for Weight Management: Retrospective National Data from the POWER Study Group.

Background: There are no existing multisite national data on obese youth presenting for pediatric weight management. The primary aim was to describe BMI status and comorbidities among youth with obesity presenting for pediatric weight management (PWM) at programs within the Pediatric Obesity Weight Evaluation Registry (POWER).

Methods: Data were collected from 2009-2010 among 6737 obese patients ages 2-17.

Graded Exercise Testing in a Pediatric Weight Management Center: The DeVos Protocol.

Background: In this article, we describe a protocol used to test the functional capacity of the obese pediatric patient and describe the peak oxygen consumption (VO2peak) of patients seeking treatment at a pediatric weight management center.

Methods: One hundred eleven (mean age, 12.5 ± 3.

Social/Electronic Media Use of Children and Adolescents Who Attend the Pediatric Weight Management Programs of the COMPASS Network.

Background: Obesity is a major healthcare problem in youth and their social/electronic media (SEM) use has been described as a risk factor. Though much is known about the newer technologies youth use to communicate, little is known about what is used by those in weight management programs. The aim of this study was to determine what types of SEM, including sedentary and active video games, youth in weight management programs use and which they prefer for communicating with healthcare providers.

Improving delivery of Bright Futures preventive services at the 9- and 24-month well child visit.

Objectives: To determine if clinicians and staff from 21 diverse primary care practice settings could implement the 2008 Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd edition recommendations, at the 9- and 24-month preventive services visits.

Methods: Twenty-two practice settings from 15 states were selected from 51 applicants to participate in the Preventive Services Improvement Project (PreSIP). Practices participated in a 9-month modified Breakthrough Series Collaborative from January to November 2011.