P2B299: Improving Clinician Knowledge and Confidence in Managing Pediatric Obesity and Diet-related Chronic Diseases After a Quality Improvement Initiative

Purpose/Objectives: Approximately 17% of youth aged 2-19 years in the U.S. have obesity. The AAP and USPSTF offer evidence-based approaches for pediatric obesity care. Although barriers to adherence may be multifactorial, confidence has been identified as a primary issue by pediatric primary care providers. Our objective was to improve clinician confidence and knowledge in the diagnosis and management of pediatric obesity.

Design/Methods: A needs assessment was completed in Fall of 2019 along with a preliminary chart review from February 2020 - February 2021 for patients with obesity. Based on the assessed gaps, key drivers and interventions were developed as part of a Quality Improvement initiative. Interventions were centered on supporting clinician knowledge in providing more efficient and evidence-based care for patients with obesity. Prior to its implementation, a 47 question pre-intervention survey was sent to clinicians that participated in the QI initiative. Of those, 13 questions addressed clinician self-identified confidence and knowledge regarding diagnosing and managing pediatric obesity and weight-related chronic diseases on a Likert scale of 0 to 3. Quality improvement interventions took place between March 2021-March 2022 with individual clinician feedback also given during the first 6 months of the intervention. After completion of the project, post-intervention Likert scale surveys were sent to clinicians utilizing an identical 0 to 3 scale as mentioned above. A Fisher exact test was used to assess statistical differences in clinicians’ attitudes toward pediatric obesity care.

Results: There were 38 responses in the pre-survey and 14 in the post-survey. We report the pre- and post-test frequency of Likert responses (Table 1). We found that there was a significant increase in the proportion of clinicians with increased confidence/knowledge in managing obesity and other comorbid chronic diseases. Prior to the intervention, 57.9% of respondents indicated moderate or high confidence in their management of children with obesity which increased to 92.9% post-intervention (p=0.02). However, there was no significant change in confidence diagnosing diabetes, dyslipidemia, and PCOS, indicating further support may be needed. Analysis of pre- and post-intervention surveys demonstrated an overall positive and significant change in clinician attitudes toward the diagnosis and management of pediatric obesity

Conclusion/Discussion: The results of this study show that QI is an effective tool that can be utilized to improve clinician confidence and knowledge in providing more evidence-based care of pediatric obesity.