title: Six to success: improving primary care management of pediatric overweight and obesity.
abstract: BACKGROUND
  Despite the existence of established guidelines addressing pediatric obesity, many primary care providers fail to successfully implement recommendations. This study measured the impact of Six to Success, a weight management program based on the Chronic Care Model, on primary care provider adherence to pediatric weight management guidelines.
  
  
  METHODS
  We used comprehensive pre- and postimplementation chart audits (N = 396) to conduct a quality improvement study at a hospital-based pediatric outpatient clinic. Charts of patients with a body mass index percentile at or above the 85th percentile (preimplementation, n = 90; postimplementation, n = 97) were audited for 23 identification, assessment, and prevention measures recommended in the care of the pediatric overweight/obese patient.
  
  
  RESULTS
  Statistically significant improvements to clinical guideline adherence were found in the following areas: correct diagnosis, physical examination, lifestyle assessment, use of motivational interviewing, and prevention strategies.
  
  
  CONCLUSIONS
  These findings suggest that Six to Success can be an effective method of improving primary care provider adherence to established pediatric weight management guidelines.
authors.forename: Heide R
authors.initials: HR
authors.lastname: Cygan
authors.forename: Kathleen
authors.initials: K
authors.lastname: Baldwin
authors.forename: Lynn Gettleman
authors.initials: LG
authors.lastname: Chehab
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rodriguez
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Zenk
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D020000:Decision Support Systems, Clinical; D055317:Evidence-Based Practice; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D016487:Parenting; D010290:Parents / Q000193:education*; D063766:Pediatric Obesity / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods*; D058996:Quality Improvement; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*
keywords: Childhood obesity; chronic care model; primary care