title: Promoting growth interpretation and lifestyle counseling in primary care.
abstract: OBJECTIVE
  To pilot a practice-directed intervention to promote growth interpretation and lifestyle counseling during child health supervision visits.
  
  
  METHODS
  The intervention at 4 diverse primary care practices included education, facilitation by a practice-change leadership team, tools, and guidance from the study team. Preintervention and postintervention evaluations used were clinician interviews, in-office surveys of parents, 1-month post-visit telephone survey, visit observations, and medical record reviews. Outcomes evaluated growth interpretation documentation, clinician recognition of overweight, topic discussed at health supervision visit, and parental visit content recall and health behavior changes.
  
  
  RESULTS
  The intervention was well accepted, and tools provided were deemed helpful. Documentation of growth interpretation was higher after intervention (pre versus post: 32% vs 87%; P< .001). Parent reports of topics discussed were similar between evaluation periods (pre versus post: growth 96% vs 99%; diet 90% vs 93%; physical activity 81% vs 85%). Observed topics at health supervision visits were similarly high and were unchanged between periods. Parental recall of topics at 1 month was also high and similar between periods. Parental report of adoption of a healthier behavior for themselves or their child at 1 month did not significantly change.
  
  
  CONCLUSIONS
  The Systematic Nutritional Assessment in Pediatric Practice intervention provides a promising model to increase interpretation and documentation of growth.
authors.affiliation: Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Chicago, IL, USA. aariza@childrensmemorial.org
authors.forename: Adolfo J
authors.initials: AJ
authors.lastname: Ariza
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Laslo
authors.forename: J Scott
authors.initials: JS
authors.lastname: Thomson
authors.forename: Roopa
authors.initials: R
authors.lastname: Seshadri
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Binns
mesh_terms: D000293:Adolescent; D000886:Anthropometry / Q000379:methods*; D015992:Body Mass Index; D002641:Chicago; D002648:Child; D002675:Child, Preschool; D006128:Growth; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008019:Life Style; D009765:Obesity / Q000517:prevention & control*; D010290:Parents; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment