667 - Improving Pediatric Obesity Screening and Counseling Using the 5-2-1-0 Framework: A Quality Improvement Project

Publication Number: 4653.667

Mai Vue, Valley Children's Healthcare, Madera, CA, United States; Navya Katragadda, Valley Children's Healthcare, Madera, CA, United States; Jeffrey Chu, Valley Children's Hospital, Madera, CA, United States; Venkata Sushma Chamarthi, Valley Children's Healthcare, Madera, CA, United States; Vanessa Rocha, Valley Children's Healthcare, Fresno, CA, United States

Background: Childhood obesity within the Central Valley continues to remain high, creating a huge burden for families and perpetuating healthcare disparities. In 2019, about 40.9% of fifth graders, 39.4% of seventh graders, and 36.6% of ninth graders had a BMI greater than the 85th percentile. Nearly 48.8% of overweight or obese teens come from low-income households. Two major problems we identified that may be contributing to the obesity epidemic were inconsistent documentation of nutrition and physical activity counseling and the lack of a standardized tool for obesity prevention counseling. Many patients also have comorbid factors including prediabetes/diabetes, hypertension, asthma, and obstructive sleep apnea, among others. We thus sought to implement a quality improvement (QI) project to increase documentation using the 5-2-1-0 questionnaire and counseling rates for nutrition and physical activity among adolescents aged 12–18 years at Dakota Pediatrics from 0% to 90%.

Objective: We aim to increase documentation and counseling rate for nutrition and physical activity among adolescents aged 12-18 at Dakota Pediatrics from 0-90% by November 2025.

Design/Methods: Baseline data were obtained through a retrospective chart review of 30 adolescents, documenting BMI, demographics, comorbidities, counseling status, and laboratory testing. The intervention involved providing the 5-2-1-0 handout and counseling during well-child visits, documented in EPIC. The 5-2-1-0 tool promotes:

· 5 or more servings of fruits and vegetables daily
· 2 hours or less of recreational screen time
· 1 hour or more of physical activity daily
· 0 sugary drinks (encouraging water intake)

After 30 days, families were contacted to assess lifestyle changes. The project received IRB exemption through Valley Children’s Healthcare.

Results: Over a 4-week period, 30 adolescents completed the baseline 5-2-1-0 questionnaire. Preliminary findings demonstrated modest improvements across all lifestyle domains following implementation. Detailed analysis of counseling rates, documentation improvements, and behavioral outcomes will be presented at the PAS 2025 Conference.

Conclusion(s): Implementation of a structured 5-2-1-0 tool improved documentation consistency and patient engagement in healthy behaviors. Early results demonstrate feasibility in a primary care setting. Final intervention outcomes and data will be presented at the PAS 2025 Conference.