title: Implementation of clinical practice guidelines for pediatric weight management.
abstract: OBJECTIVE
  To evaluate the effect of computer-assisted decision tools that standardize pediatric weight management in a large, integrated health care system for the diagnosis and management of child and adolescent obesity.
  
  
  METHODS
  This was a large scale implementation study to document the impact of the Kaiser Permanente Southern California Pediatric Weight Management Initiative. An average of 739, 816 outpatient visits per year in children and adolescents from 2007 to 2010 were analyzed. Height, weight, evidence of exercise and nutrition counseling, and diagnoses of overweight and obesity were extracted from electronic medical records.
  
  
  RESULTS
  Before the initiative, 66% of all children and adolescents had height and weight measured. This increased to 94% in 2010 after 3 years of the initiative (P < .001). In children and adolescents who were overweight or obese, diagnosis of overweight or obesity increased significantly from 12% in 2007 to 61% in 2010 (P < .001), and documented counseling rates for exercise and nutrition increased significantly from 1% in 2007 to 50% in 2010 (P < .001).
  
  
  CONCLUSIONS
  Computer-assisted decision tools to standardize pediatric weight management with concurrent education of pediatricians can substantially improve the identification, diagnosis, and counseling for overweight or obese children and adolescents.
authors.affiliation: Kaiser Permanente Medical Group, Department of Research and Evaluation, Pasadena, CA, USA. Karen.J.Coleman@kp.org
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Coleman
authors.forename: Anne C
authors.initials: AC
authors.lastname: Hsii
authors.forename: Corinna
authors.initials: C
authors.lastname: Koebnick
authors.forename: Ana F
authors.initials: AF
authors.lastname: Alpern
authors.forename: Brenna
authors.initials: B
authors.lastname: Bley
authors.forename: Marianne
authors.initials: M
authors.lastname: Yousef
authors.forename: Erin M
authors.initials: EM
authors.lastname: Shih
authors.forename: Keila J
authors.initials: KJ
authors.lastname: Trimble-Cox
authors.forename: Ning
authors.initials: N
authors.lastname: Smith
authors.forename: Amy H
authors.initials: AH
authors.lastname: Porter
authors.forename: Steven D
authors.initials: SD
authors.lastname: Woods
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003658:Decision Making, Computer-Assisted; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000628:therapy*; D050177:Overweight / Q000453:epidemiology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000592:standards / Q000706:statistics & numerical data*