Clinical trial NCT03648242: Improving Pediatric Obesity Practice Using Prompts
Official title: Improving Pediatric Obesity Practice Using Prompts (iPOP-UP): Using Electronic Health Records to Support Decision-Making in Pediatric Obesity Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pediatric Obesity
Keywords: pediatric obesity
electronic health record
clinical decision support
Lead sponsor: Yale University
Sponsor class: OTHER
Collaborators: name: Boston Children's Hospital
First posted: 2018-08-27
Enrollment: 140
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: HEALTH_SERVICES_RESEARCH

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.

Detailed description: The primary specific aims of this study are to:

1. To assess the impact of EHR-based tools for pediatric obesity in primary care. Hypotheses: EHR-based clinical decision support tools that interrupt but support clinical workflow will (1) improve measures of pediatric obesity care quality delivered by clinicians (e.g., addition of obesity to the problem list, recommended screening for comorbidities, and follow-up/referral plans) and (2) result in a reduced rate of BMI increase over one year among children with obesity.
2. To utilize a mixed methods approach with surveys and semi-structured qualitative interviews with clinicians to (1) examine the extent to which the EHR tools positively impact clinicians' awareness, knowledge and adherence to expert guidelines for pediatric obesity management, and (2) to explore the barriers to and facilitators of clinicians' use of the EHR tools and factors that influence adoption.

Eligibility criteria: 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.

Primary outcomes:
measure: Change in body mass index (BMI)
timeFrame: 1 year pre-intervention, baseline, and 1 year post-intervention
measure: Change in percent BMI above the 95th percentile (%BMIp95)
timeFrame: 1 year pre-intervention, baseline, and 1 year post-intervention
measure: Change in documentation of elevated BMI diagnosis
timeFrame: 1-year pre-implementation compared to 1-year post-implementation
measure: Change in proportion of patients with obesity
timeFrame: 1-year pre-implementation compared to 1-year post-implementation
measure: Change in proportion of patients with obesity who have counseling for obesity-related behavior change documented in the EHR
timeFrame: 1-year pre-implementation compared to 1-year post-implementation
measure: Change in proportion of patients with obesity with follow-up or referral orders
timeFrame: 1-year pre-implementation compared to 1-year post-implementation
Secondary outcomes:
measure: Change in provider knowledge, attitudes and practice around obesity management in primary care assessed via an electronic surveys and qualitative interviews of clinicians
timeFrame: baseline compared to 6 months post-implementation
measure: System usability scale (SUS) score
timeFrame: 6 months post-implementation
Other outcomes:
Locations:
city: Boston
country: United States
facility: Boston Children's Hospital
state: Massachusetts
Study officials:
affiliation: Boston Children's Hospital
name: Corinna Rea, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: