Primary Care, Communication, and Improving Children's Health

The University of Texas System (UT)

Status: Completed

Conditions: Weight Loss; Overweight; Childhood Obesity; Communication

Treatments: Other: Risk-factor assessment and counseling; Other: Patient-centered communication; Other: Lifestyle behavior assessment and counseling; Other: Interval follow-up to readdress weight; Other: Communication regarding overweight status

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT02277899

1K23HL118152-01A1 Aim 2

1K23HL118152-01A1 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this study is to determine communication content and strategies in primary care that predict improvement in weight status among overweight school-age children.

Full description

We will test whether 1) pediatrician-patient communication regarding overweight status, behavior/risk-factor counseling, and the frequency and time to next follow-up visit, compared with either no communication or incomplete communication (communicating only high weight status without behavior/risk-factor counseling or a follow-up visit) will predict improvement in weight status at one year follow-up, and 2) during pediatrician-patient communication regarding weight and weight management, higher patient-centeredness will predict improvement in weight status at one year follow-up. The communication content identified will generate new information about the most effective content and style of pediatrician-patient communication that predict weight-status improvement. Because we prospectively will examine clinical practice elements in the one-year interval between well-child visits, acknowledging that communication regarding high weight status may initiate assessment of risk factors for heart disease (such as high cholesterol and blood sugar), more frequent follow-up visits, or prompt a nutrition referral, we will generate novel information about the most effective clinical practices and follow-up interval and frequency that predict weight-status improvement in overweight children. We also will examine if the content and style of communication are related to improvements in diet and lifestyle behaviors at one-year follow-up.

Enrollment: 100 patients

Sex: All

Ages: 6 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Schedule a well-child visit with a participating pediatrician
• Agree to return in one year for the follow-up well-child visit
• Overweight
• 6-12 years old
• Have a working telephone and/or e-mail address
• Child/parent willing to provide assent/consent

Exclusion criteria

• Unstable illness (such as uncontrolled asthma)
• Developmental condition (such as trisomy 21)
• Planning to move/leave practice within two years

Trial design

100 participants in 1 patient group

Overweight school-age children

Description:

Overweight 6-12 year-old children. Weight status will be measured and parents complete surveys at baseline and one year later. Pediatricians will complete surveys at baseline, and after index visit. Visits will be directly video-recorded. The impact of pediatrician clinical practices and communication strategies on child's weight status will be evaluated at one year. Clinical practices (such as risk-factor screening) that occur during the 1-year interval between well-child visits also will be assessed. Specific clinical practice elements and communication strategies that will be examined include: 1. Communication regarding child's high weight status 2. Counseling regarding cardiovascular risk factor screening and assessment 3. Behavioral counseling 4. Interval follow-up to readdress weight, and 5. Patient-centeredness, scored as the ratio of patient to doctor-centered communication regarding weight topics.

Treatment:

Other: Risk-factor assessment and counseling

Other: Communication regarding overweight status

Other: Patient-centered communication

Other: Interval follow-up to readdress weight

Other: Lifestyle behavior assessment and counseling