Location: Children's Nutrition Research CenterTitle: Effect of parental selection of healthy behavior topic during well child visit on plan to change childs eating or physical activity behavior) Author
Submitted to: Pediatric Academic Society
Publication Type: Abstract only
Publication Acceptance Date: 3/30/2009
Publication Date: 5/1/2008
Citation: Barlow, S.E., Arceo, D., Butte, N.F. 2009. Effect of parental selection of healthy behavior topic during well child visit on plan to change childs eating or physical activity behavior [abstract]. Pediatric Academic Society. E-PAS, 2816.172. Interpretive Summary:
Technical Abstract: Current recommendations direct pediatricians to address obesity and obesity prevention routinely during well child visits and to tailor their counseling, but clinicians may feel ineffective because of time constraints and lack of parent interest. To prompt parents to select a healthy lifestyle topic to review with the pediatrician during the well child visit and to test the effect of this intervention on the parent's report at the end of the visit of a plan to change an eating or activity behavior for their child. This intervention was designed to minimize change in the structure and flow of the office visit. In 2 pediatric offices, all families with children 3 to 14 years of age scheduled for a well child visit received a letter before the visit that encouraged them to choose 1 or 2 of 8 topics about healthy eating and physical activity. At the office, parents who agreed to enroll received 1 or 2 handouts matching the chosen topics to review with the pediatrician. Visits were otherwise unchanged. In 2 control offices, the well child visits were conducted as usual. In all 4 offices, each child's weight and height were recorded, and each parent completed a questionnaire after the visit. 178 of 248 (71.7%) parents approached in the intervention offices and 206 of 262 (85.1%) parents in the control offices agreed to participate. The groups were similar in child's mean BMI z score. Compared with the control group, the intervention group had more girls (53.6% vs 43.8%), a different racial/ethnic distribution, and lower parental education level. Overall 92.5% of the parents in the intervention group reported plans to change one or more of child's eating or activity behaviors after the visit compared with 69.3% in the control group (p < 0.001). Higher BMI and racial/ethnic minority status were associated with plan to change. In a logistic regression model, controlling for child BMI z-score, gender, age, race/ethnicity, and parent education, the odds ratio of the intervention group reporting plan to change was 6.69 (95th % CI = 3.16, 14.2; p < 0.001). Parent selection of eating or physical activity topic and discussion of the topic with the pediatrician increased the parent's reported plans to make a change in the child's behavior. Telephone interview to follow-up are planned.