A unique collaboration between UPMC Health Plan, Children's Community Pediatrics (CCP), and Children's Hospital of Pittsburgh of UPMC is utilizing a multidisciplinary team approach in the setting of the pediatrician's office to provide practical weight management strategies for children who are obese or overweight.
The pediatric weight management program -- which is for children age 19 and under -- includes promotion of best practice clinical guidelines, condition monitoring, and disease stratification. The program involves an assessment of physical and behavioral health, compliance and adherence with a treatment plan, and patient education that supports self-management. The program was launched this month at 27 CCP practices located in eight counties throughout western Pennsylvania.
The initial obesity treatment assessment will be made by the child's pediatrician who can then make a referral to either a newly developed in-office program or, in more acute cases, to the Weight Management and Wellness Center at Children's Hospital of Pittsburgh of UPMC.
"We are delighted that this unprecedented, cooperative effort will help make progress in the fight against obesity in young people," said Diane P. Holder, President and CEO of UPMC Health Plan. "The foundation of this program is what family members request when seeking weight management treatment for their children -- they want the pediatrician involved, they want the program to be held at a convenient location, and they want it covered by their health plan.
"Our intent is that this program will help to prevent the progression of pediatric obesity and reduce the chance that these children will develop illnesses such as diabetes and heart disease, which are specifically related to excess weight."
Over the past 30 years, the childhood obesity rate has more than doubled for preschool children, ages 2-5, and more than tripled for children ages 6-11. For adolescents ages 12-19, the rate has more than doubled. Approximately 9 million children ages 6 and above are considered obese.
"Children's Hospital is committed to improving the health and well-being of all the children in the communities we serve, not just the patients who come through the doors of the hospital," said Christopher Gessner, President, Children's Hospital. "This is an innovative and unique approach to the childhood obesity epidemic in that we're trying to identify children who are at risk for obesity and intervene -- in the primary care setting -- before they develop complex conditions related to obesity."
At the discretion of the physician, a child who is selected for the pediatric in-office weight management program and is a UPMC Health Plan member receives a comprehensive set of private lifestyle consultations with a nurse/lifestyle counselor. During each four-month treatment phase, the child receives three lifestyle counseling visits with the nurse and one with the pediatrician. With a pediatrician's recommendation, the program lasts for up to one year. The entire cost of the program will be covered by UPMC Health Plan. UPMC Health Plan is also providing support materials and training.
"The strength of our approach is that we have provided our nurses with extensive training as lifestyle coaches and specialized training in motivational interviewing so they can work with the patient and the entire family, to help them make lifestyle changes that can result in weight loss, a reduction in body mass index and, most important, healthy behaviors that will last a lifetime," said David Wolfson, MD, CCP Medical Director. "This all takes place in the patient's medical home (pediatrician's office) -- where they already feel comfortable going for physical, behavioral, and other needs."
Statistics indicate that almost one-third of U.S. adults are considered obese and the prevalence of obesity has more than doubled in the past half century. An estimated 17 percent of children in the U.S. are overweight and overweight children have a 70 percent chance of becoming overweight or obese adults.
"As both the provider and payer of medical services, UPMC is in a unique position to be a national leader providing innovative solutions in the fight against childhood obesity," said Madelyn H. Fernstrom, PhD, CNS, Director of Nutrition and Weight Management for UPMC Health Plan, who led the development of the program. "With a greater likelihood of overweight and obese children becoming overweight adults, we must begin obesity intervention early with an eye to prevention. This program is a major step in the right direction."