title: Virtual obesity collaborative with and without decision-support technology.
abstract: OBJECTIVE
  The purpose of this study was to evaluate school-based health center (SHBC) provider adherence to guidelines for identification and assessment of childhood obesity after participation in a virtual Health Disparities Learning Collaborative with and without HeartSmartKids™, decision-support technology with tailored patient education.
  
  
  METHODS
  A cluster randomized comparative effectiveness trial was conducted with 24 SBHCs from six states.
  
  
  METHODS
  The sample consisted of 33 SBHC providers and review of medical charts at three time points. Chart data were collected at baseline (n = 850), after training (n = 691) and 6 months after training (n = 612).
  
  
  METHODS
  Charts from a random sample of youth 5-12 years making well-child visits were examined for the documentation of: BMI percentile, accurate weight diagnosis based upon BMI percentile, blood pressure percentile, and ordering appropriate laboratory assessment of obese youth ≥10 years old.
  
  
  RESULTS
  Percentage of overweight/obese children in this study was 40.4-47.2%. For both the HeartSmartKids™ and non-HeartSmartKids™ groups, provider adherence significantly improved after training for BMI percentile and blood pressure percentile documentation, as well as correct diagnosis for overweight and obese. Implementation of the HeartSmartKids™ was variable at the technology sites and differences in identification and assessment were not found between groups.
  
  
  CONCLUSIONS
  The virtual collaborative approach to quality improvement resulted in improved adherence to guidelines for identification and assessment of overweight/obese children. The impact of the training with and without HeartSmartKids™ on patient outcomes needs to be evaluated. Coaching on implementation of technology needs to be included in future work.
authors.affiliation: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA bonnie.gance-cleveland@ucdenver.edu.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Gance-Cleveland
authors.affiliation: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Aldrich
authors.affiliation: Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schmiege
authors.affiliation: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Tyler
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D057186:Comparative Effectiveness Research; D003661:Decision Support Techniques; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration* / Q000592:standards; D008297:Male; D050177:Overweight / Q000175:diagnosis / Q000628:therapy; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D012572:School Health Services / Q000458:organization & administration* / Q000592:standards; D014584:User-Computer Interface
keywords: Virtual Health Disparities Learning Collaborative; childhood obesity; school-based health centers; decision–support technology; childhood obesity guideline adherence