Community based case management program to address childhood obesity in an urban population

Overweight and obesity rates have skyrocketed over the last two decades and obesity is now the most prevalent health concern for children. In the Boston Public schools, 40-45% of all children are either overweight or obese. Addressing this requires interventions outside of the traditional medical treatment model. Case management in community health centers has evoloved as an effective intervention to connect overweight and obese patients to necessary services to address health disparities, improve health outcomes and build community capacity.

This obesity management program was developed with the aim of building the capacity of 11 community health centers to manage obesity in children. Community health centers are the source of primary care for the majority of the city's urban children. In this model, health center primary care providers have been educated and encouraged to ensure BMI measurements are recorded and assessed for all pediatric patients. Children who are identified as overweight or obese are referred to the on site case manager, who is either a nutritionist or a social worker. The case manager engages the child/family in both nutrition education and physical activity.

Services are provided to over 1,000 children per year. This non medical model has shown a statistically significant impact on decreasing consumption of sugar sweetened beverages, increasing physical activity, and decreasing TV watching. BMI results show mean BMI z-scores decreased from 2.03 to 1.96 (p<.001) and the mean BMI percentile decreased from 0.0960647 to 0.095147 (p<0.01).