Developing a patient-centered outcome for targeting early childhood obesity across multiple stakeholders 11 Medical and Health Sciences 1117 Public Health and Health Services

Byron (Alex) Foster, Paula Winkler, Kelsey Weinstein, Deborah Parra-Medina

Research output: Contribution to journalArticle

Abstract

Background: Patient-centered outcome measures for childhood obesity are limited. Identifying outcomes that patients and families consider important could be a viable avenue for better engagement of patients and interventions that are efficacious and acceptable to patients. Latino children experience high rates of obesity, and under-recognition of obesity in preschool aged children is common. Methods: We used growth chart data to identify low-income, Latino children 2-5 years of age with obesity who decreased their adiposity (positive deviants) and a set of controls. We used qualitative interview data to identify themes around goals parents used in addressing weight. Then, we applied a modified Delphi approach across groups of caregivers and providers to identify common goals. We conducted focus groups to explore conflicts and congruency between caregivers and providers related to goals. Using the focus group data, we developed a decision tool for use between patients and providers relevant for early childhood obesity. Results: We identified 257 children who successfully reduced adiposity (positive deviants) from 1621 eligible growth charts. From interviews with 44 parents (21 positive deviants and 23 controls), we coded and categorized outcomes such as increased happiness, clothing size and improved activity. We recruited 81 parents, grandparents and health care providers to participate in the modified Delphi process of ranking outcomes by importance and feasibility. Focus groups (2, total n = 24) suggested potential methods for a common framework to discuss goals, including a modified growth chart. We created a decision-tool that incorporated a growth chart and a section for discussion of patient-centered goals. A final focus group (1, n = 10) provided feedback on the tool as acceptable and potentially useful. Conclusions: The development of a patient-centered tool around achieving a healthy weight in early childhood identified common goals between providers and parents. While the tool has been developed, prospective testing of this patient-centered tool and its effects on engagement, parent motivation, and behavior change would be a useful next step.

Original languageEnglish (US)
Article number39
JournalBMC Obesity
Volume5
Issue number1
DOIs
StatePublished - Dec 3 2018

Fingerprint

Pediatric Obesity
Health Services
Growth Charts
Public Health
Focus Groups
Health
Parents
Obesity
Adiposity
Hispanic Americans
Caregivers
Interviews
Patient Participation
Weights and Measures
Happiness
Clothing
Preschool Children
Health Personnel
Motivation
Outcome Assessment (Health Care)

Keywords

  • Delphi technique
  • Goals
  • Growth charts
  • Latino
  • Low-income population
  • Obesity
  • Patient-centered outcomes research
  • Positive deviance
  • Preschool children
  • Shared decision making

ASJC Scopus subject areas

  • Epidemiology
  • Endocrinology, Diabetes and Metabolism
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Developing a patient-centered outcome for targeting early childhood obesity across multiple stakeholders 11 Medical and Health Sciences 1117 Public Health and Health Services. / Foster, Byron (Alex); Winkler, Paula; Weinstein, Kelsey; Parra-Medina, Deborah.

In: BMC Obesity, Vol. 5, No. 1, 39, 03.12.2018.

Research output: Contribution to journalArticle

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