title: TeleFIT: adapting a multidisciplinary, tertiary-care pediatric obesity clinic to rural populations.
abstract: Pediatric obesity occurs most frequently in underserved communities where families have difficulty accessing healthcare. Disproportionate obesity rates in rural children denote significant disparities warranting innovative solutions. However, intensive, tertiary-care treatment options outlined in recent expert recommendations may not be available to families living in rural areas. Telemedicine may be useful for providing pediatric obesity treatment to rural families. The aim of this study was to assess the impact of a new outreach program (TeleFIT), which placed telemonitors in four rural satellite clinics to increase access to a pediatric obesity clinic (Brenner Families In Training [FIT]). Before TeleFIT began, of five patients from rural counties enrolled in treatment over a 1-year period, all dropped out by their third visit. Within the first year of TeleFIT, the number of rural patients increased nearly threefold (to 14) and increased again in the second year by an additional 16 new patients (n=35). Preliminary outcomes indicate comparable attrition rates and improvement in weight status compared with patients in conventional treatment. Telemedicine allows rural families to access intensive obesity treatment from local pediatric offices, eliminating geographic barriers. Systems delivering state-of-the-art care in rural areas have tremendous potential for reducing health disparities in rural populations. Further research is needed to test the efficacy of such interventions.
authors.affiliation: Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
authors.forename: Megan B
authors.initials: MB
authors.lastname: Irby
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Boles
authors.forename: Christine
authors.initials: C
authors.lastname: Jordan
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Skelton
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D009657:North Carolina; D009765:Obesity / Q000628:therapy*; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration*