O3029: The Healthy Living Visit Pilot: Implementing the Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity in Primary Care

Purpose/Objectives: The Healthy Living Visits quality improvement project aims to operationalize the AAP Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity in the primary care setting through increased clinician training, expansion of programs and services for patients, and engaging a multidisciplinary team.

Design/Methods: Participating pediatricians from sites across Children’s Primary Care Medical Group (CPCMG), a 29-site pediatrics single-specialty group, receive quarterly training on components of the Clinical Practice Guidelines, including: (1) clinical practice guideline algorithm including diagnosis, labs, medication, and surgical options; (2) how to talk about weight and weight bias; (3) motivational interviewing skills training; and (4) case studies, plus an optional session on how to use and prescribe WeGovy. Previously, participating clinicians received specialized training in delivery and monitoring of a 6 monthly 20-minute theme-based coaching sessions, to be delivered either in person or through video visit, addressing 5210, sleep, social/emotional wellness for children with obesity and related comorbidities. Clinicians may refer any Healthy Living Visit patients for additional video, phone, or MyChart-message-based health coaching with a health coach and access to robust online patient resources. Health coach referral is required for patients on obesity medication. Clinicians also have access to a more intensive specialty clinic for obesity (WELL Clinic), a virtual teaching kitchen, and mindfulness sessions, all available through CPCMG. The Healthy Living Visits materials are incorporated into an Epic Smartset. Participating clinicians are approved to receive 25 points of MOC-4 credit.

Results: Forty-four clinicians at 20 sites are enrolled in the Healthy Living Visits training program. Visit numbers, MOC-4 completion, percentage of patients with Med-Cal insurance, clinician confidence in the treatment of childhood obesity, and medication prescribing and insurance approvals and denials are being monitored over the course the of year-long program.

Conclusion/Discussion: This MOC-4 approved obesity management program offers an approach to implement the Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity in the primary care setting by (1) increasing clinician knowledge and competence in the guidelines, medication prescribing, and healthy living principles and behavioral modification, and (2) offering access to health coaching, robust online resources, and a defined curriculum.