Use of electronic health record to recruit obese adolescents for a lifestyle modification weight management clinical trial

BACKGROUND: Adolescent and childhood obesity are among the nation's most prevalent and devastating chronic diseases of childhood. Identification and treatment of adolescent obesity falls short in primary care settings, particularly in medically under served populations (rural, urban african american).

PURPOSE: We employed the use of an electronic registry derived from a fully-integrated electronic health record (EHR) to recruit obese teens to participate in a 12 month randomized clinical trial comparing self-guided to group manual based lifestyle modification program.

METHODS/SETTING: Geisinger Health System's EHR from 38 practice sites in central/northeastern Pennsylvania was searched for children ages 12-16 with height and weight recorded at same visit since 2004. Body mass index (BMI) was calculated and compared to the Centers for Disease Control's age specific percentiles. In addition to public advertisements, an IRB approved letter from study physicians was sent to “parents of” adolescents from the registry with a BMI>28 to invite them to participate in a weight management study. Source of recruitment, numbers of parent calls, and number of consents signed by parents are reported.

RESULTS: Of adolescents' ages 12-16 identified in the EHR, 3691 had a BMI> 28. Letters were sent to 698 parent-teens who live within a 40 minute commute to study site to invite them to participate in a weight management study. We received 77 phone calls and consented 40 teens/parents, 34 who reported the recruitment letter as source of information about the study. 5% of the parents who received recruitment letters consented to the clinical trial (34/698).

DISCUSSION: These data demonstrate how electronic health record information can be used to identify and recruit obese adolescents and their parents in a medically under served, rural area to participate in a weight management clinical trial conducted in a primary care setting.