592 - Baseline Capacity for Implementing Intensive Health Behavior and Lifestyle Treatment in Variable Pediatric Care Settings

Publication Number: 4580.592

Jeremiah Salmon, American Academy of Pediatrics, Itasca, IL, United States; E. Jeanne Lindros, American Academy of Pediatrics, Itasca, IL, United States; Meghan Perkins, Mass General Brigham, Boston, MA, United States; Lauren Fiechtner, MassGeneral Hospital for Children, Boston, MA, United States

Background: The 2023 AAP Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity (CPG) recommends that pediatric health care providers (PHCPs) offer intensive health behavior & lifestyle treatment (IHBLT) to all patients 2-18 yrs. with overweight (OV) or obesity (OB). The Healthy Weight Clinic (HWC) is a CDC-recognized Family Healthy Weight Program (FHWP) that delivers IHBLT. PHCPs often lack the capacity to offer recommended treatment to their patients, so capacity-building is vital for providers participating in HWC.

Objective: The objective of this analysis was to assess assets and gaps reported by PHCPs within baseline capacity assessments as part of an attempt to scale and spread the HWC program nationally.

Design/Methods: As part of the virtual quality improvement (QI) to support the adoption and implementation of HWC, PHCPs build capacity to routinely provide OV/OB treatment visits and longitudinal care. To help focus their improvement work, PHCPs initially complete a multi-dimensional organizational capacity assessment, developed for this and similar projects.

Results: At baseline, HWC PHCPs commonly reported having dedicated programmatic team and treatment focused meetings, high levels of organizational support and non-stigmatizing practice environments (Figure 1). The % staff trained was consistently low to moderate across topics, with particularly low levels reported for HWC standards, weight bias/stigma, billing/coding and QI methods (Figure 2). The HWC PHCPs commonly reported having dedicated programmatic team and treatment focused meetings, high levels of organizational support and non-stigmatizing practice environments (Figure 2). PHCPs generally had considerable capacity regarding team roles and electronic health record (EHR) space for evaluation-focused care (Figure 3) and less capacity for treatment-focused care, which held true for nearly all aspects of EHR space (Figure 4). PHCPs reported significant planning to address systems/strategies for tracking patients, coordinating care, assessing patient attrition and program costs, and maintaining and communicating with key partners (Figures 5 & 6). Limitations associated with primary uptake by early adopters that paid for the program and supports.

Conclusion(s): Baseline capacity assessments of early adopters of the HWC suggest that HWC PHCPs often had considerable assets in place at baseline to support integration of evidence-based IHBLT programming within their settings. Identified gaps suggest possible opportunities to enhance staffing, early training and dedicated EHR space to support longitudinal care.

Figs 1&2
Figure 1. Meetings, Environment & Organizational Support; Figure 2. HWC Team & Training

Figs 3&4
Figure 3. Team Roles & EHR Space for Evaluation; Figure 4. Team Roles and EHR Space for Treatment

Figs 5&6
Figure 5. Operation Systems & Strategies; Figure 6. Maintenance Systems & Strategies