ArticlePediatric quality & safety
Enhancing Pediatric Obesity Management through Quality Improvement: A Hybrid Approach to Intensive Health Behavior and Lifestyle Treatment in Primary Care.
Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Intensive health behavior and lifestyle treatment (IHBLT) programs can improve weight and reduce comorbidities for children with obesity, but implementation in primary care remains limited. Baseline performance at our institution showed low referral volume, limited participation, and insufficient treatment intensity, indicating gaps in program reach and adoption. Methods: Utilizing the model for improvement, we led a quality improvement initiative in a large urban academic primary care clinic to increase IHBLT referrals, participation, and treatment intensity. Sequential plan-do-study-act cycles tested provider education, standardized and culturally tailored materials, a hybrid in-person-and-virtual program structure, and engagement strategies. We tracked three process measures: referrals, participation, and program intensity. We tracked outcomes using individuals-moving-range (X-mR) statistical process control charts. Results: Statistical process control analysis demonstrated that program participation and intervention intensity met Provost criteria for a sustained shift, whereas referral volume demonstrated primarily common-cause variation. Improvements in participation and intervention intensity were maintained over time, with centerlines recalculated to reflect updated process performance. Moving range charts indicated stable variation across all measures. Conclusions: An iterative, context-responsive system redesign improved the delivery of evidence-based pediatric obesity treatment in our primary care setting. The hybrid IHBLT model, combining in-person visits and technology-supported touchpoints, was associated with sustained gains in participation and treatment intensity, whereas referral volume remained stable. This pragmatic approach leverages existing resources and offers a feasible pathway for primary care clinics seeking to implement guideline-concordant IHBLT while addressing common logistical and equity-related barriers.
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Registered trials
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