Dissemination and Implementation of the Connect for Health Pediatric - - PowerPoint PPT Presentation

Dissemination and Implementation of the Connect for Health Pediatric Weight Management Program

Meg Simione, PhD

Project Director @megsimione September 20, 2019

Holly Frost, MD

Clinician Champion

Elsie M. Taveras, MD, MPH

Principal Investigator @elsiemt

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Meg Simione, PhD

• Has nothing to disclose.

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Holly Frost, MD

• Has nothing to disclose.

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Connect for Health Pediatric Weight Management Program

• A proven effective, multilevel intervention
• To improve childhood obesity screening, management, and body

mass index (BMI)

• Clinician and family-facing tools

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Connect for Health Randomized trial 2-12 year-olds with overweight or obesity 6 pediatric offices in MA 721 children 1 year duration Intervention Components:

• Electronic decision support;
• Behavior change materials;
• Text messaging;
• Neighborhood resources;
• Health Coaching

Outcomes:

• Changes in BMI z-score
• Child quality of life
• Behavioral change

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Connect for Health Bundle

Family materials

• Educational

materials to support behavior change self- management;

• Text messages;
• Connections to

resources.

Boston Natural Areas Network Free guided walks, hikes, rock climbing, and canoe & bicycle trips Make sleep a priority. Stick to regular bedtime and wake times for your child. Drink water. Have 0 sugary drinks.

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Connect for Health Bundle

Electronic health record (EHR) tools for clinicians

• Flagging of children with BMI ≥ 95th percentile;
• Clinical decision support tools to guide screening and

management;

• Provider training.

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Implementation Sites

• Pediatric primary care practices in three healthcare systems that

serve a diverse patient population

6 practices 9 practices 7 practices

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Optimizing and Adapting Connect for Health

• Clinician interviews

& parent surveys

• Assessed needs,

perspectives, preferences, and barriers and facilitators to program uptake

• Preliminary findings
• Clinicians wanted

resources to address pediatric weight management and preferred tools that were culturally appropriate and enhanced patient care without disrupting workflow

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Optimizing and Adapting Connect for Health

• Customizing the program
• EHR tools
• Clinician training
• Patient educational materials and text messaging

program

• Community based resources

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Engagement of Key Stakeholders

• Meetings with key stakeholders
• Family Advisory Council
• Community Advisory Council
• Community-Based Board of Director

meetings

• Child Health & Advocacy Professional

Advisory Council

• Pediatric Quality Improvement

Committees

• Primary Care Medical Directors meeting
• Unit Chief meetings
• Medical Assistant Council

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Implementation Strategies

• EHR screening and clinical

decision support tools

• Clinician champions and

practice coaches for “at the elbow support”

• In-person trainings
• Tutorials and manuals
• Virtual learning

communities

Strategies to support integration into practice Strategies to increase knowledge

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Evaluation

Patient-centered outcomes

Outcome Source Parent’s experiences with care Parent surveys using the Patient Assessment of Chronic Illness Care Changes in child BMI BMI from EHR

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Evaluation

Implementation outcomes

Outcome Definition Source Reach How many children will receive this program? HEDIS* measures Adoption How many clinicians and parents use the program tools? EHR tool audits; text messaging audits Fidelity What is the adherence to the intended program? Clinician interviews and

• bservations

Appropriateness What is the perceived fit of the program? Clinician interviews Maintenance How is the program sustained after the study period is over? EHR tool audits

*Healthcare Effectiveness Data and Information Set

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Lessons Learned & Key Take-Aways

• Being responsive to the needs of clinicians, staff, and families is

essential – stakeholders at all sites want to be involved in the decision-making process

• Workflows and EHR builds vary greatly across healthcare systems

– customizing for sites is key

• A staggered roll-out allows for minor modifications and

adjustments

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Learn More

• www.pcori.org
• info@pcori.org
• #PCORI2019
• www.c4hprogram.com

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Questions?

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Thank You!

Meg Simione, PhD

Project Director @megsimione

Holly Frost, MD

Clinician Champion

Elsie Taveras, MD, MPH

Principal Investigator @elsiemt