Healthy Active Living Program - Akron Children's …...Toolkit •5-2-1-0 Revolution handout and magnet •Consider wall posters for exam rooms Healthy Active Living Toolkit Weekly

Healthy Active Living

Program

Experts believe this is the first generation of children to have a shorter lifespan than

their parents

“Our public health approach to the epidemic has largely failed so far ”

Commentary: Epidemic Childhood Obesity: Not Yet the End of the Beginning, David Ludwig MD, PhD, Pediatrics 2018

- Dr. David Ludwig

Objectives

•Review weight management options

•Review available resources for prevention and intervention of childhood obesity

•Explain the role of the Healthy Active Living Program

Weight Management Options

•PREVENTION

•PRIMARY CARE STAGED INTERVENTION

•REFERRAL


•PREVENTION


•REFERRAL


PREVENTION • The best treatment for childhood overweight and obesity is prevention

• Prenatal/birth and ages/stages

• AAP Building a Foundation for Healthy Active Living

• Parenting at Mealtime and Playtime (Ohio AAP)

• 5210 messaging at all well child visits regardless of BMI

• Aggressive intervention at 85th-95th


•PREVENTION


•REFERRAL


PRIMARY CARE INTERVENTION• Follow AAP algorithm

• AAP resources

• Use ACH PCP toolkit

• Use obesity smart set

• Consider starting healthy habits group at your location (Ashland)

• CLOSE F/U

Resources

AAP Digital Resources:

• Institute for Healthy Childhood Weight

• Podcast: Conversations about Care

AAP Books/Media:

• 5210

• Next Steps

• The Family Fit Plan

• The Picky Eater Project

Ohio AAP:

• Parenting at Mealtime and Playtime

Resources

Obesity Medical Association (OMA)• Pediatric Obesity Algorithm

• Online Education/Webinars

• Obesity Medicine Education Collaborative

Upcoming Conference • Pediatric Obesity Management: Evidence-based Strategies and Practical Approach

• AAP Headquarters

(APRIL 3-4, 2020)


•PREVENTION


•REFERRAL


REFERRAL OPTIONS• Nutrition services/RD ONLY

• Healthy Active Living Clinic

• MV: Chronic Care Education and Support

• Note: Some specialties have their own RDs

Changes to Healthy Weight Clinic

• Healthy Weight Clinic has been rebranded to the Healthy Active Living program

• Healthy Active Living has a better undertone than asking kids to attend a “weight

clinic”

• New name emphasizes lifestyle change while incorporating the important

elements of physical activity & nutrition

• Addition of surgical arm

Healthy Active Living Services

• Medical and nutritional assessments

• Diagnosis and management of co-morbidities

• Dietary recommendations

• Exercise counseling/FITT Rx

• Assessment of physical activity levels

• Mental health evaluation/counseling referral

• Behavioral modification and management

Healthy Active Living Clinic Services

Regional sites

Multi-disciplinary team clinic

Bariatric surgery program

Healthy Active Living Clinics

Regional Specialty Care Clinic• Ages 2-18 y , BMI > 95%

• Location-based

• Medical provider only, no team

• Will refer to psych, tertiary care team if needed

• Currently: Green, MV

• Potential for telemedicine, group visits


Hospital-based Clinic• Multidisciplinary Team (MD/NP, Psych, RD, EP, SW)

• Ages 2-18 years, BMI > 95%

• Surgical and non-surgical interventions

• Monthly visits for at least 6 months

• Clinics offered Monday through Thursday

• Medical evaluation to include labs if not done by PCP


Bariatric Surgery Program

• Patients 14-22 years old (may refer at 13 to start process)

• BMI >40 or BMI >35 with comorbidity

• Surgical option should no longer be considered a treatment of last resort

References: Pediatrics 2019; Volume 144AAP News December 2019American Society for Metabolic and Bariatric Surgery: Pediatric Guidelines 2018

Logistics

• The Healthy Active Living and Bariatric Clinics are part of Ambulatory Peds (no longer Sports med/Endo)

• One central phone # 330-543-5673

• Referral in Epic: type in healthy, etc

• Contact: Clinic Coordinator, Melissa Sommers, RN

Healthy Active Living TeamClinical Coordinator

• Melissa Sommers, RN

Medical Providers• Michelle Levitt, MD• Marnie Walston, MD• Amy Perusek MSN,CNP

Psychologist• Geoffrey Putt, PsyD

Dietitians• Katie Dougherty• Laura Iberkleid

Exercise PhysiologistAmy Chand

Social Worker• Lisa Broerman, LISW-S

Summary: childhood obesity is an epidemic

• Prevention and primary care intervention are important and needed

• Use toolkit to easily open conversation and be clear in discussing the importance/urgency

• Follow treatment stages using algorithm and obesity smart set (unless bariatric candidate)

• Be clear on referral: try not to refer to RD/nutrition services and HAL team (stages)

• Follow-up monthly/quarterly even if referred out, especially if multiple referrals and/or mental health

concerns

• Surgical treatment option is underutilized: refer ALL patients who meet criteria to Bariatric clinic

(severe obesity is unlikely to resolve with medical/lifestyle treatment alone)


Questions?

Healthy Active Living PCP Toolkit

• Designed to facilitate the discussion about weight in the office setting

• AAP Algorithm to assess and manage childhood obesity in the primary care setting

• Use w/obesity smart set

Healthy Active Living Toolkit

• BMI charts for boys and girls

• Reverse side: Red zone, why worry? Discusses potential risks


• Healthy Habits Assessment

• Assessment and motivational interviewing tool to direct next steps


• 5-2-1-0 Revolution handout and magnet

• Consider wall posters for exam rooms


Weekly tracker:

✓fruit/veggie intake

✓ screen time

✓physical activity

✓sugary drinks


• Rx pad to “prescribe” treatment plan/written goals


Thank you!


Regional care services

Basic Programming• Medical evaluation/labs (if not done by PCP)

• Rethink Your Drink (sugar)

• Smart Start (protein, breakfast)

• Veggies Matter (carbs, fiber, F & V)

• Healthy Fats (snacks)

• Sleep & Physical Activity

• Individualized for medical severity

• Ranked a Best Children’s Hospital by U.S. News & World Report

• Magnet® Recognition for Nursing Excellence

• Largest independent pediatric provider in northern Ohio

• 2 hospital campuses

• 60+ locations offering primary care, specialty services and urgent care

• 5,800 employees

• With more than 1 million patient visits each year, we’ve been leading the way to healthier futures for children and communities through expert medical care, prevention and wellness programs since 1890.

About Akron Children’s

Documents

Healthy Active Living Program - Akron Children's …...Toolkit •5-2-1-0 Revolution handout and magnet •Consider wall posters for exam rooms Healthy Active Living Toolkit Weekly