The Pediatric Practice Research Group (PPRG) is a well-established primary care research network in the Chicago area. It is a diverse network representing an array of patients across racial and ethnic groups and socioeconomic categories, with a research agenda that includes the study of preventive care delivery, particularly related to nutritional health. Its directors are supported within Children's Memorial Hospital and the Department of Pediatrics, Feinberg School of Medicine, Northwestern University. This pilot study will test the implementation of a program to aid health providers in the interpretation of child growth and the routine delivery of nutritional counseling in two PPRG practices. The program includes a practice educational intervention and the use of a computerized system using newly-developed software that has the ability to track growth and provide personalized handouts about child nutrition according to child age and nutritional status categories.
The aims of the study are to: 1) determine changes effected by the program in the rates of identification of overweight or at risk for overweight children, in the provision of counseling on healthy behaviors, and in patient flow; 2) assess practice use of and reactions to the new systems; 3) obtain feedback that will lead to improvements in the proposed changes to common practice processes and the software; and 4) examine the cost of implementing this system. The proposed program will be implemented at 2 diverse practices, one with a majority of white, privately-insured patients and the other a community health center serving low-income African American and Hispanic patients. This study will use visit observations and medical record reviews to evaluate practice system changes and care delivery. Acceptance of the system by the practice members will be done through practice member survey and interviews of key informants. Through this pilot study, we will test and refine the implementation of the computerized system. The program has been developed by the PPRG based on findings from other PPRG studies. The program could change the delivery of care to allow practices to more easily include routine growth interpretation and child-specific counseling on healthy behaviors, thus increasing the motivation of physicians to address this key area. This pilot will provide sufficient data to support wide-spread evaluation of the program across an array of diverse practice settings.
