Implementation of a pilot primary care lifestyle change intervention for families of pre-school children: lessons learned.
OBJECTIVE
We used Glasgow's RE-AIM framework to evaluate the feasibility of a primary care-based intervention to decrease behaviors that place urban children at risk for obesity.


METHODS
During preventive visits of 2-5-year olds between February 2006 and May 2007, parents completed a health behavior assessment. Primary care providers engaged parents in brief goal setting and referred them to a lifestyle counselor. Evaluation involved medical record review, interviews with staff and clinicians, and health behavior assessment via a pre- and post-intervention telephone survey.


RESULTS
Families reached by the intervention did not differ from families who were not. The intervention was adopted by 14 of 17 clinicians. The health assessment was implemented in 32% of preventive visits (N=354). Of those, goal setting by physicians occurred in 59%, with 55% referred to the lifestyle counselor. We were unable to demonstrate effectiveness to change adult or child nutrition or physical activity, as complete data were available for only 34 families.


CONCLUSIONS
Goal setting with referral for more intensive lifestyle counseling for obesity prevention in high risk families is feasible and acceptable in primary care.


CONCLUSIONS
Patient educators can be integrated into primary care to achieve preventive care goals.
McKee
M Diane
MD
Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY, USA.
Deen
Darwin
D
Maher
Stacia
S
Fletcher
Jason
J
Fornari
Alice
A
Blank
Arthur E
AE
D015992:Body Mass Index; D002675:Child, Preschool; D016001:Confidence Intervals; D037001:Directive Counseling / Q000379:methods*; D005196:Family Therapy; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008019:Life Style; D008297:Male; D015999:Multivariate Analysis; D009519:New York City; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D010865:Pilot Projects; D011320:Primary Health Care; D016730:Program Development; D015397:Program Evaluation; D012044:Regression Analysis; D012307:Risk Factors; D040241:Social Marketing; D011795:Surveys and Questionnaires