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| ID | Type | Description | Link |
|---|---|---|---|
| 1K08HS024332-01A1 | U.S. AHRQ Grant/Contract | View source |
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| Name | Class |
|---|---|
| Boston Children's Hospital | OTHER |
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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.
The primary specific aims of this study are to:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interruptive Clinical Decision Support | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 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:
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| Measure | Description | Time Frame |
|---|---|---|
| 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 |
| Measure | Description | Time Frame |
|---|---|---|
| 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 |
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All pediatric primary care providers providing well child care for patients ages 2-17 years-old in the Boston Children's Hospital primary care practices will be eligible for the study. There are no exclusion criteria.
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| Name | Affiliation | Role |
|---|---|---|
| Corinna Rea, MD, MPH | Boston Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Boston Children's Hospital | Boston | Massachusetts | 02115 | United States |
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| ID | Term |
|---|---|
| D063766 | Pediatric Obesity |
| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
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the system usability scale is a validated 10-item measure of system usability
| 6 months post-implementation |
| D009750 |
| Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |