Purpose of Study The CDC's National Health and Nutrition Examination Study (NHANES) reports that nearly 15% of children are classified as overweight. Currently, the standard of care for pediatricians does not include routinely recording a height and weight at sick visits. This limits the ability of pediatricians to establish data regarding children who are at risk for overweight and those who are overweight. This study hypothesized that less than 20% of BMIs would be recorded by pediatricians at two clinic sites. Chart reviews were conducted at two public health clinics to determine the percentages of BMIs being calculated by pediatricians at each site. An additional aim of this study was to provide an educational intervention designed to increase the rate of BMIs being calculated and plotted and to retest clinics at 3 months.
Methods The research team reviewed 1047 charts of children who received care in the last 6 months at two clinics located in an urban area of Jacksonville, Florida. Eight hundred ninety six (896) charts were included in the study and data recorded consisted of date of clinic visit, date of birth of the child, gender, race, height, and weight (when available), whether or not a BMI was calculated and plotted in the chart, and whether or not the child was covered under public health insurance (additional data were collected for further studies.)
Summary of Results This study found that of 896 charts, only 55 or 6% contained a BMI. While one clinic performed better in calculating and plotting BMIs than the other (clinic 1 = 9% and clinic 2 = 1%), overall rates were very low. An educational intervention was conducted at the two clinics to determine if the intervention would increase the number of BMIs being recorded by pediatricians. Post intervention data are currently being collected and will be included in the poster presentation to determine if a change occurred.
Conclusions Results from this study suggest that a very low percentage of BMIs are currently being conducted and recorded in patients' charts by pediatricians. This may imply that pediatricians may not have a clear indication of how many children in their practice would fall into the CDC's BMI-for-age-gender specific categories of overweight, at risk for overweight, acceptable, or underweight. Further studies are needed to confirm that other practices also report low rates of BMIs being recorded. These data may be helpful in encouraging pediatricians to routinely calculate and plot BMIs, to identify patients at risk for overweight and those who are overweight, and to not miss educational opportunities with their patients.
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