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Healthy Weight Management in a Health Care Home: A Feasibility Study

Healthy Weight Management in a Health Care Home: A Feasibility Study. Katharine Wickel, MS, LAMFT Jerica M. Berge, PhD, MPH, LMFT, CFLE Dianne Neumark-Stzainer , PhD, MPH. Objectives. Understand the progression from focus group to intervention within a primary care Health Care Home.

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Healthy Weight Management in a Health Care Home: A Feasibility Study

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  1. Healthy Weight Management in a Health Care Home: A Feasibility Study Katharine Wickel, MS, LAMFT Jerica M. Berge, PhD, MPH, LMFT, CFLE Dianne Neumark-Stzainer, PhD, MPH

  2. Objectives • Understand the progression from focus group to intervention within a primary care Health Care Home. • Understand how Health Care Homes can be utilized in additional ways to treat adolescent female obesity. • Learn innovative ways to treat obesity for racial/ethnically and socio-economically diverse families.

  3. Adolescent Obesity • Obesity among children has doubled in the past two decades (Ogden, Carroll, Curtin, Lamb, & Flegal, 2010) • Increased risk of hypertension, cardiovascular disease, metabolic syndrome, type 2 diabetes, and psychosocial problems • Adolescents from low-income families and who belong to racial/ethnic minorities are disproportionately at higher risk (Singh, Kogan, Van Dyck, & Siahpush, 2008)

  4. Adolescent Obesity • Significant associations between weight gain and dieting, dissatisfaction with body image, and teasing about weight and familial encouragement to diet (Field et al., 2003; Haines, Neumark-Sztainer, Wall, & Story, 2007; Neumark-Sztainer et al., 2006; Neumark-Sztainer et al., 2007) • Innovative approaches are needed to address such a complex problem

  5. Focus Groups • Triadic-level feedback • Parents (n = 11) • Pre-adolescent girls (n= 9) • Adolescent Girls (n = 21) • Clinic Staff at Health Care Home primary care clinic (n = 14) • Community-based participatory approach • Based on community and clinic needs

  6. Focus Groups • Goals/Questions to be Answered: • Would the intervention fit into a busy, outpatient primary care clinic? • Would the adolescents and their parents be satisfied with the intervention? • Feedback from participants regarding their current dietary and physical activity patterns and their knowledge/understanding regarding body image

  7. Methodology • Adolescent girls (and parents) recruitment • Primary care clinic in a low-income and racially/ethnically diverse neighborhood • Electronic Medical Records • Primary care providers (Behavioral health, medical residents, and 3rd year medical student) • Eligibility • Age, Weight Status, Gender, English speaking/reading)

  8. UMatter (i.e. YOU Matter!) • Intervention for girls ages 10-14 • One of her parents also attends • 7 Educational sessions • First and last are measurement sessions • Parents come to 5 of the sessions (including measurement sessions) • Every session includes healthy snack/meal and physical activity

  9. UMatterSessions • Daughter Sessions • Healthy Eating • Body Image • Family Meals • Physical Activity • Weight Talk and Teasing • Parent Sessions • Modeling • Family Meals • Communication

  10. UMatter • Home Visits • Goal setting with parent-daughter dyad • Motivational interviewing • Social Media Component • Google+ • Incentives

  11. Participants • Spring 2013 (n = 7)* • Fall 2013 (n = 14)* • Currently on-going *Indicates number of mother-daughter dyads.

  12. Initial Findings • Typical Goals • Daughters • Work on flexibility • Take family walks • Eat healthier and cook meals together • Learn new exercises • Parents • Play ball with daughter • Go for more walks • Have meals together as a family

  13. Initial Findings • Successes • Daughters • Trying yoga • Jump roping • Family talks more • Family discussions about healthy eating • Parents • Maintain good, healthy attitude • Eating healthier meals • Walking as a family

  14. Feedback – Parents • Best part of the program? • “Getting to share stories with the other parents…setting goals and actually doing them, and I learned a lot from coming to the class about how to approach questions, or, I would say, basically how I could have discussions with [my daughter] about weight. That was one of the most important things I learned.” • “Spending time with my daughter and learning new ways to communicate.”

  15. Feedback – Parents • What did you learn? • “How to approach conversations with [my daughter] about her weight or my weight. Or over all, even other people’s weight…I try not to think negative now when I see over weight people.”

  16. Feedback – Daughters • What was your favorite lesson? • “Working on body image. [We] talked about what it means to stay healthy and what our body would be like.” • What did you think about having your mom being involved? • “It felt less [scary], so we wouldn’t be here by ourselves. I wasn’t as shy. Usually my first time doing something I’m more shy.”

  17. Feedback – Daughters • What did you learn? • “Be more active. To eat a lot more healthy foods. To stretch a lot.” • “Learned how we could eat healthy.” • Would you do the program again? • “Yeah, I loved it!”

  18. Final Thoughts • Results from the pilot study will inform the development of an NIH R01 application for a full Randomized Controlled Trial (RCT).

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