| Autor: |
Yudkin JS; The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA., Allicock MA; The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA.; Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA., Atem FD; The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA.; Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA., Galeener CA; The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA., Messiah SE; The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA.; Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA.; Department of Pediatrics, McGovern Medical School, Houston, Texas, USA., Barlow SE; Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA. |
| Abstrakt: |
Clinical weight management programs face low participation. The authors assessed whether using electronic health record (EHR) data can identify variation in referral, consent, and engagement in a pediatric overweight and obesity (OW/OB) intervention. Using Epic EHR data collected between August 2020 and April 2021, sociodemographic and clinical diagnostic data (ie, International Classification of Disease [ICD] codes from visit and problem list [PL]) were analyzed to determine their association with referral, consent, and engagement in an OW/OB intervention. Bivariate analyses and multivariable logistic regression modeling were performed, with Bayesian inclusion criterion score used for model selection. Compared with the 581 eligible patients, referred patients were more likely to be boys (60% vs. 54%, respectively; P = 0.04) and have a higher %BMI p95 (119% vs. 112%, respectively; P < 0.01); consented patients were more likely to have a higher %BMI p95 (120% vs. 112%, respectively; P < 0.01) and speak Spanish (71% vs. 59%, respectively; P = 0.02); and engaged patients were more likely to have a higher %BMI p95 (117% vs. 112%, respectively; P = 0.03) and speak Spanish (78% vs. 59%, respectively; P < 0.01). The regression model without either ICD codes or PL diagnoses was the best fit across all outcomes, which were associated with baseline %BMI p95 and health clinic location. Neither visit nor PL diagnoses helped to identify variation in referral, consent, and engagement in a pediatric OW/OB intervention, and their role in understanding participation in such interventions remains unclear. However, additional efforts are needed to refer and engage younger girls with less extreme cases of OW/OB, and to support non-Hispanic families to consent. |
