Pediatric Obesity Reduction at Access Community Health Network, Austin Family Health Center
Investigators
Abdel Fahmy, M.D. (Internal Medicine)
Illur Sathy, M.D. (Pediatrics)
Summary: The ACCESS Austin Family Health Center, 5835 West North Avenue in Chicago
serves
a community whose characteristics align with a high and increasing incidence
of child obesity. This
center is one of 44 Federally Qualified Community Health Center sites within
Access Community
Health Network (ACCESS), a PHS 330 grantee organization that provides community-based
primary
health care in low income, medically underserved Chicago area neighborhoods.
With a CLOCC
grant, this center has initiated development of a pediatric-focused obesity
program based on previous
successes with a formal obesity management program for adults.
Significance
National and Chicago area studies indicate that
child obesity is increasing at a faster
rate within low socioeconomic status Latino and African American communities.
In 2004, the
ACCESS Austin Family Health Center had almost 4,000 unique patients, with
approximately 66%
African-American and 15% Latino. Additionally, over 15% of the unique African-American
and Latino patients were in the 5-14 year old age range. The ACCESS
Austin Family Health Center’s
CLOCC obesity program centers on a medical management regime supplemented
by group sessions
facilitated by a social worker and health education staff.
Project Design and
Subject Selection
Recognizing that a complex mix of factors contribute
to overweight and obese children and that obesity in children occurs with
greater frequency when at
least one parent is obese, the ACCESS Austin Family Health Center model focuses
on overweight
children who have at least one obese adult from the same family who also
agrees to participate in the
program. Participants will be drawn from the current health center patient
population based on a
weight index and health status protocol, up to a maximum of 30 total child
and adult participants. As
a community health center, the program can accept all eligible patients regardless
of ability to pay.
The study intervention will span six months in spring and summer of 2005. The intervention includes individual medical screening and family-centered counseling regarding adjustment of caloric intake and exercise. Each participant will be expected to attend at least two monthly group sessions to increase their understanding of proper nutrition and physical activity and the way in which both contribute to health promotion (assessed by pretest and post-test). One monthly session will provide an educational program, involving nutrition and/or physical activity. The second session led by a licensed clinical social worker will promote intergenerational group discussion to explore perceptions, reactions, and challenges with respect to their goals. The group visits will also provide participants opportunities for individual meetings with the physicians.
Patients from the ACCESS West Division Family Health Center, 4401 West Division Street, whose patient population mirrors the ACCESS Austin Family Health Center will be identified and tracked for comparative data.
Data Collection and Analysis
Data concerning weight,
body mass index, relevant health
indicators, adherence to diet, and exercise and level of group participation
will be collected and
analyzed monthly to compare weight loss to other health and participation
factors. Further, the
project will seek patient satisfaction data and feedback regarding
the intervention model and the
relative advantages of intervening with same age as well as with intergenerational
cohorts.
Anticipated Results
We anticipate that 70% of participants
will attend 75% (or 18 of 24) of the
group sessions. The center will obtain greater understanding of how
management of nutrition and exercise can be facilitated in
a community health center and neighborhood context and how intergenerational
interventions affect success with weight loss, motivation, knowledge
attainment, and
attention to weight issues over a sustained period. The relationship
between patient attainment of
goals and their ability to locate an exercise venue in the community
will also be explored, and results
will be used to shape future programming.
Significance of this Work
Access Community Health Network is
currently building upon the work of Dr. Ed Wagner to develop programs
for chronic disease management. This program allows the
ACCESS Austin Family Health Center to pilot an approach to reduction
of childhood obesity using a
group visit model adapted for use with children in the context of
adult weight management.
Information from this project will be used to refine protocols for
an expanded effort that can be
implemented to a broader population and replicated in other Access
Community Health Network
health centers.
