Improving Pediatric Obesity Practice Using Prompts

NCT03648242 | Completed

• 2 other identifiers: 20000263821K08HS024332-01A1
• Study Type: interventional
• Target: 140
• Locations: 1 country
• Sites: 1

Brief Summary

This study compares the effectiveness of electronic health record (EHR)-based tools to support the management of pediatric obesity in primary care. All clinicians will receive an interruptive "pop-up" alert We will examine the impact -- the added value versus unintended consequences -- of the interruptive alert on the quality of obesity management in pediatric primary care.

Conditions

Pediatric Obesity

Keywords

pediatric obesity; electronic health record; clinical decision support

Outcome Measures

Primary Outcomes (6)

• Change in body mass index (BMI)

  change in BMI, calculated from height and weight measured as part of routine clinical practice during primary care clinic visits and documented in the EHR

  1 year pre-intervention, baseline, and 1 year post-intervention

• Change in percent BMI above the 95th percentile (%BMIp95)

  Change in percentage of age/sex-adjusted BMI above the 95th percentile (%BMIp95), calculated from height and weight measured as part of routine clinical practice during primary care clinic visits and documented in the EHR

  1 year pre-intervention, baseline, and 1 year post-intervention

• Change in documentation of elevated BMI diagnosis

  Change in proportion of patients with obesity who have elevated BMI documented in the EHR

  1-year pre-implementation compared to 1-year post-implementation

• Change in proportion of patients with obesity

  Change in proportion of patients with obesity who receive age-appropriate screening for comorbidities (blood measure measurement and age-appropriate laboratory screening)

  1-year pre-implementation compared to 1-year post-implementation

• Change in proportion of patients with obesity who have counseling for obesity-related behavior change documented in the EHR

  1-year pre-implementation compared to 1-year post-implementation

• Change in proportion of patients with obesity with follow-up or referral orders

  1-year pre-implementation compared to 1-year post-implementation

Secondary Outcomes (2)

• Change in provider knowledge, attitudes and practice around obesity management in primary care assessed via an electronic surveys and qualitative interviews of clinicians

  baseline compared to 6 months post-implementation

• System usability scale (SUS) score

  6 months post-implementation

Study Arms (1)

Interruptive Clinical Decision Support

EXPERIMENTAL

Behavioral: Interruptive Clinical Decision Support

Interventions

Interruptive Clinical Decision Support BEHAVIORAL

An interruptive, "soft-stop" alert will pop up when a pediatric primary care provider open a child's electronic health record (i.e., a new window in the forefront of the screen interrupting workflow and requiring the clinician to take an action) alerting them that the child meets criteria for obesity based on their age/sex-specific BMI percentile. The pop-up alert includes: * One-click addition of elevated BMI to problem list * Reminder to utilize Suggested PowerPlan * One-click access to a patient handout on evidence-based behavior change goals (screen time, sugary drinks, physical activity, sleep) and link to additional handouts and resources * Tables displaying trends in growth measures, blood pressure and relevant laboratory tests * Links to existing, evidence-based childhood obesity screening and management guidelines

Interruptive Clinical Decision Support

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

Sponsors & Collaborators

• Yale University: lead
• Boston Children's Hospital: collaborator

Study Sites (1)

Boston Children's Hospital

Boston, Massachusetts, 02115, United States

Location

MeSH Terms

Conditions

Pediatric Obesity

Condition Hierarchy (Ancestors)

Obesity; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Corinna Rea, MD, MPH

  Boston Children's Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 21, 2018
• First Posted: August 27, 2018
• Study Start: September 1, 2018
• Primary Completion: September 30, 2020
• Study Completion: December 31, 2020
• Last Updated: May 17, 2021

Record last verified: 2021-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)