Using Health IT to bridge clinic and community in the fight against childhood obesity

Obesity in children is one of the great healthcare challenges of the early 21st century. Responses to the obesity epidemic from the healthcare community have been fractured and inconsistent for reasons including poor reimbursement, lack of evidence-based solutions, and poor provider self-efficacy in counseling. The path to health for each family should be discussed in the medical office but the implementation of that plan must be in the community. In addition, attention to prevention requires that health resources must be made available to all families regardless of weight status. This research effort used health informatics, specifically provider decision support, to connect clinics to community health information and an obesity intervention. The intervention is a family-centered, community-based obesity treatment delivered by trained non-experts from community organizations. It was created with the participation of academic researchers, medical and family resource staff from a local clinic, the local recreation center, and community healthy living groups. Five clinics, including four school-based health centers, were equipped with decision-support technology to increase implementation of national medical guidelines for the assessment, prevention, and treatment of childhood obesity. The decision-support technology was configured to automatically deliver geographically and temporally relevant information on healthy community resources to each family. Families of eligible children received an invitation to the next intervention session; others received information on healthy eating and activity resources within the community. In the 19 months since implementation, behavioral, anthropometric, and motivational information was gathered on 1992 children by the decision support system. Of those children, 748 were given information on the intervention. Fifty-four families with 122 children have attended nine sessions. This presentation will describe the flow of patients and information in a healthy living program that includes partners from healthcare, public recreation, health informatics, and academia.