Population Effects of MI on Pediatric Obesity in Primary Care
| Status: | Recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 3 - 11 |
| Updated: | 10/14/2018 |
| Start Date: | July 1, 2017 |
| End Date: | May 31, 2021 |
| Contact: | Kennet Resnicow, Ph.D. |
| Email: | kresnic@umich.edu |
| Phone: | (734) 904-3888 |
Population Effects of Motivational Interviewing on Pediatric Obesity in Primary Care
In this cluster randomized effectiveness trial, pediatric primary care practices will be
recruited from the American Academy of Pediatrics' national Pediatric Research in Office
Settings (PROS) practice-based research network, as well as the client database of the
Physician's Computer Company (PCC) - an Electronic Health Record (EHR) vendor. We will
recruit 18 practices. 9 practices will be randomized to the Intervention arm and 9 practices
to Usual Care. Intervention arm practices will select 1-2 pediatric clinicians to receive
in-person training in Motivational Interviewing (MI), behavioral therapy, billing and coding,
and study procedures. Usual Care practices will select 1-2 pediatric clinicians to receive
billing / coding and study protocol training only, via telephone and webinar; they will be
offered in-person MI training at the close of the trial. Around 316 parents of overweight or
obese children (BMI > 85th percentile for age and gender) between 3 and 11 years of age at
baseline that are patients of participating Intervention arm clinicians will be enrolled.
Over 24 months, these parents may receive up to 4 in-person, MI-based counseling sessions
with a trained pediatric clinician and up to 6 telephone counseling sessions with an
MI-trained Registered Dietician (RD). There will be no study-specific contact with parents or
their children in Usual Care practices during the trial - they will continue to receive usual
care. EHR and billing data for all 3-11 year old children within all participating practices
will be extracted by PCC to permit determination of the effectiveness of the intervention
versus usual care on change in BMI z-score among 3 groups: 1) all eligible children in the
Intervention arm), 2) all eligible children whose parent actively participates in the trial ,
and 3) all 3-11 year old children in all participating practices.
recruited from the American Academy of Pediatrics' national Pediatric Research in Office
Settings (PROS) practice-based research network, as well as the client database of the
Physician's Computer Company (PCC) - an Electronic Health Record (EHR) vendor. We will
recruit 18 practices. 9 practices will be randomized to the Intervention arm and 9 practices
to Usual Care. Intervention arm practices will select 1-2 pediatric clinicians to receive
in-person training in Motivational Interviewing (MI), behavioral therapy, billing and coding,
and study procedures. Usual Care practices will select 1-2 pediatric clinicians to receive
billing / coding and study protocol training only, via telephone and webinar; they will be
offered in-person MI training at the close of the trial. Around 316 parents of overweight or
obese children (BMI > 85th percentile for age and gender) between 3 and 11 years of age at
baseline that are patients of participating Intervention arm clinicians will be enrolled.
Over 24 months, these parents may receive up to 4 in-person, MI-based counseling sessions
with a trained pediatric clinician and up to 6 telephone counseling sessions with an
MI-trained Registered Dietician (RD). There will be no study-specific contact with parents or
their children in Usual Care practices during the trial - they will continue to receive usual
care. EHR and billing data for all 3-11 year old children within all participating practices
will be extracted by PCC to permit determination of the effectiveness of the intervention
versus usual care on change in BMI z-score among 3 groups: 1) all eligible children in the
Intervention arm), 2) all eligible children whose parent actively participates in the trial ,
and 3) all 3-11 year old children in all participating practices.
Inclusion Criteria:
- For Practices: Currently use Physician's Computer Company (PCC) as their Electronic
Health Record (EHR) vendor
- For Clinicians: Have been employed by the practice for at least 1 year on or before
July 1, 2017 Work > half time (at least 6 sessions per week)
- For Parents: Parent or legal guardian of a child that meets the following criteria: At
least 3 but not yet 12 years of age on the date of the baseline data pull (estimated
to occur in the summer or fall of 2017). BMI for age and gender > 85th percentile -
documented at an office visit that occurred during the 12 months prior to the baseline
data pull. Most recent well-child visit was with a participating study clinician
during the 24 months prior to the baseline data pull
Exclusion Criteria:
- For Practices: Offer a comprehensive weight loss program or access to a RD at or
through the practice. Unable or unwilling to send all participating study clinicians
to in-person training.Unable or unwilling to identify and assign a study coordinator
for the study
- For Clinicians: > 1 day of prior training in MI within the past 10 years. Prior
participation in the AAP/PROS Healthy Lifestyles Pilot Study (HLS; AAP IRB protocol #
01SC01) or Brief Motivational Interviewing to Reduce Body Mass Index (BMI2) Study (AAP
IRB protocol # 07RE01).
- For Parents: Does not speak either English or Spanish. Parent or legal guardian of a
child who has any of the following documented in their EHR: Type I or Type II
diabetes. Daily or chronic use of medications known to affect growth and mood /
behavior (growth hormones, SSRIs, stimulants).Use of atypical antipsychotics. A
chronic, limiting, severe medical disorder, syndrome, or other condition (e.g., Downs
syndrome, cerebral palsy)
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