1. A PROGRAM TO PROVIDE TREATMENT FOR CHILDHOOD OVERWEIGHT AND OBESITY By Kimberly Deppe Northern Kentucky University DNP 806 July 2013

2. INTRODUCTIONTHE WHY? 3. INTRODUCTION: Epidemic Co-morbidities Treatment Future 4. GOAL 1 Develop a partnership with the local healthcare providers, functioning as a resource for the healthcare providers and their clients related to childhood overweight and obesity 5. OBJECTIVES: 1.a. Increase the number of children and youth screened during routine physical assessment for overweight and obesity and related chronic disease risk factors using nationally established guidelines for screening and referral as evidenced in health history, assessment and diagnosis in the EMR for the child 1.b. Engage local practices in routinely discussing obesity prevention/reduction with children and their parents, including the availability of local resources as evidenced in plan of care of EMR 1.c. Publicize resources in the medical office as evidence by brochures on display 6. GOAL 2 To decrease the prevalence of childhood overweight and obesity in our community as evidenced by decrease in number of reported cases 7. OBJECTIVES: 2.a. To increase the access to and use of environments that support healthful eating, physical activity and prevention of childhood overweight and obesity in our community as evidenced by resources being available and inviting. 2.b. To educate healthcare providers about nutrition, healthy weight and their role in counseling patients with obesity and overweight along with related chronic diseases as evidenced by education offered and attended. 2.c. To establish a support network of accessible, family-based and culturally relevant interdisciplinary weight management services for overweight children and youth as evidenced by the creation of this service 8. METHODS OF DELIVERY In service education will be provided to all providers Formal class available over lunch hour STRENGTHS: Time commitment convenient, interaction with peers for discussion WEAKNESS: time commitment outside office, providers view as insignificant health problem On-line PowerPoint presentation available STRENGTHS: ease of use and available for repeat reviews WEAKNESS: time commitment outside office, providers view as insignificant health problem 9. DELIVERY (CONT.): Development of a service available to patients through healthcare provider or self-referral Partner with local hospital STRENGTHS: room available for service, have exercise facility available to community, have professional expertise available through dietician and therapy services WEAKNESS: understanding of ambulatory service billing, view as insignificant problem, not known to community residents Partner with area bariatric center STRENGTHS: know the epidemic, expertise, resources, available collaborative physician WEAKNESS: goal of bariatric interventions, loose connection to community Partner with area healthcare providers STRENGTHS: regularly providing service to the overweight and obese children, ease of identification through EMR WEAKNESS: failure to recognize for early intervention, belief the problem cannot be resolved 10. PROGRAM MATERIALS PowerPoint presentation Pre-and Post-test of basic knowledge of overweight and obesity in children Quick reference guides for providers for identification and treatment algorithm and billing codes EMR templates for treatment visits for overweight and obese children 11. EVALUATION: GOAL-FREE MODEL Focus is how the program affects the need Evaluation establishes the need for the program Format eliminates bias, discovery of information format Focus is on the client needs and analysis of program in meeting the needs 12. EVALUATION TOOLS Tally sheets to collect data Cost analysis Patient satisfaction Provider utilization 13. EVALUATION TOOL Pt. # Who referred DOB Gender Town Payer Cost Payment Services Referrals out of clinic Met goals Tally sheet 14. PATIENT SATISFACTION SURVEY 15. COST EFFECTIVENESS Comparison of program cost to payments collected for services Evaluation of third party reimburses Development of a per visit charge to cover services compared to cost per visit 16. DATA ANALYSIS Qualitative Graphs, pie charts, bar charts Cost/benefit analysis 17. REFERENCES American Heart Association. (2013). Overweight and obesity. Statistical Fact Sheet 2013 Update. Retrieved from http://www.heart.org/idc/groups/heartpublic/@wcm/@sop/@smd/documents/downloadable/ucm_319588 .pdf American Public Health Association. (2013). Tackling childhood Obesity: Vision and Guiding Principles. Retrieved from http://www.apha.org/programs/resources/obesity/tacklingobesity.htm CMA Foundation (2008). Child & Adolescent Obesity ProviderToolkit. Retrieved from http://www.thecmafoundation.org/projects/ObesityGeneralPDFs/ChildToolkit_Revised%20April%202008. pdf Centers for Disease Control and Prevention. (2013). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/stateprograms/programGoal.html Goldstein, H. (2013). Become a child health advocate for obesity prevention in California. Medscape Family Medicine Education. Retrieved from http://www.medscape.org/viewarticle/806855?src=wnl_cme_revw Harris, J. L., Roussel, L., Walters, S. E., & Dearman, C. (2011). Project Planning and Management: A Guide for CNLs, DNPs, and Nurse Executives. Sudbury, MA: Jones & Bartlett Learning. Hirsch, L., & Gandolf, S. (2013). SWOT: The high-level self exam that boosts your bottom line. Retrieved from http://www.healthcaresuccess.com/articles/swot.html 18. REFERENCES (CONT): Health Service Executive. (2012). Training Programme For Public Health Nurses And Doctors In Childhealth. Screening, Surveillance, And Health Promotion. Retrieved from http://lenus.ie/hse/handle/10147/110557 Iowa Department of Public Health. (2013). Iowans Fit for Life: Active and Eating Smart. Retrieved from http://www.state.ia.us/iowansfitforlife/docs/Chapter_2_Goals_Objective_and_Strategiesk.pdf Kaufman, F. (2013). A focus on childhood obesity in California. Medscape Family Medicine Education. Retrieved from http://www.medscape.org/viewarticle/806794_transcript_3 Lewis, L. B. (2009). Evaluation. Retrieved from http://edtech2.boisestate.edu/lewisl/edtech505/what_evaluation.html New York State Department of Health. (2013). Strategic Plan for Overweight and Obesity Prevention. Retrieved from http://www.health.ny.gov/prevention/obesity/strategic_plan/goals.htm Wakeman, S. (2013). Program Evaluation. Retrieved from coedpages.uncc.edu/slwakema/secureRSCH6101/SPED... PPT file 19. To find humor is to understand