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APHA Scientific Session and Event Listing

Recorded presentation

Michele Polacsek, PhD, MHS¹, Joan Orr, CHES¹, Lisa Letourneau, MD, MPH², Steve Gortmaker, PhD³, and Victoria Rogers, MD⁴. (1) Maine Harvard Prevention Research Center, Maine Center for Public Health, 12 Church Street, Augusta, ME 04330, 207 629-9272, mpolacsek@mcph.org, (2) MaineHealth, 465 Congress Street, Suite 600, Portland, ME 04101, (3) Prevention Research center, Harvard School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA 02115-6096, (4) Kids' Coop, Barbara Bush Children's Hospital, 22 Bramhall Street, Portland, ME 04102

The prevalence of childhood risk for overweight and overweight is increasing at an alarming rate in Maine as it is nationally. Overweight is associated with significant health problems in the pediatric age group and is an important early risk factor for much of adult morbidity and mortality. The Maine Harvard Prevention Research Center partnered with the Maine Center for Public Health (MCPH), the Maine Chapter of the American Academy of Pediatrics, and the National Initiative for Children's Healthcare Quality to establish a Maine Youth Overweight Collaborative to improve care and outcomes for youth who are at risk for overweight or overweight. The project was funded by the Maine Health Access Foundation in the fall of 2004 for two years. Using a Planned Care Model approach, the MCPH brought together clinical experts, primary care practices, and community partners to develop local expertise and shared goals among clinical practice teams in order to improve management of and decrease youth overweight in Maine. The Collaborative focused on improving control of key behavioral and clinical risk factors as well as improving use of self-management support strategies by clinician teams and patients. Twelve practice teams were recruited statewide and agreed to 1) set specific goals and objectives for improving overweight care within the practice; 2) make specific, measurable key changes within the practice; 3) identify a leadership team to champion change within the practice; 4) attend three learning sessions; 5) provide regular reports of progress to other practices and collaborative staff; 6) communicate progress, share information about improvement changes with supporting data within the practice and with their senior leadership; and 7) identify specific steps for spreading and sustaining change within the practice. Evaluation encompassed both improvements in the process of care, as well as outcomes of care. Process measures included improvements in measuring and tracking BMI %'ile for age/gender, conducting assessments of obesity comorbidities (e.g. triglycerides, cholesterol, BP,), delivering a healthy lifestyle message, motivating behavior change and practice team improvements. Additional process measures included measures of practice team-community partnerships, changes in delivery system design, decision support, and clinical information systems progress. Bimonthly quality improvement conference calls took place to review data and make system and practice improvements. Outcome measures included provider knowledge, attitudes, beliefs, skills, practices; and patient variables. We observed significant office system improvements, practice team and provider improvements, as well as patient behavior change and satisfaction.

Learning Objectives:

• Participants will become familiar with the basic planned care model framework and how it was used to establish the Maine Youth Overweight Collaborative.
• Participants will learn the key components in how the Maine Youth Overweight Collaborative was implemented.
• Participants will become familiar with the Maine Youth Overweight Collaborative evaluation design, measures and findings.

Keywords: Medical Care, Obesity

Related Web page: www.mcph.org/KeepMEHealthy/keepmehealthy.htm

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation