Impact of an American board of pediatrics maintenance of certification (MOC) on weight-related counseling at well-child check-ups. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Cheung, Patricia C.; Gazmararian, Julie A.; Kramer, Michael R.; Drews-Botsch, Carolyn D.; Welsh, Jean A.
• Is Part Of: Patient education and counseling. Volume 102:Issue 1(2019)
• Page Start: 113
• Page End: 118
• Publication Date: 2019-01
• Subjects: Counseling -- Pediatricians -- Body weight -- Child -- Continuing education; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2018.08.024
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Few pediatricians use goal setting and health messages during counseling. Pediatrician training/decisional support increases goal setting and health messages. Maintenance of Certification programs can offer training and decisional support. Abstract: Objective: The Healthy Weight Counseling Maintenance of Certification (MOC) program integrates pediatrician training and clinic changes to promote use of evidence-based, diet and physical activity (PA) health messages and counseling strategies. This interrupted time series study assessed the impact of this MOC program on provision of weight-related counseling. Methods: We randomly selected 10–15 well-child visit charts at three time points before and three time points after 102 Georgia pediatricians began the MOC in 2012–2015. Linear binomial regression compared the frequency of behavior-change goal setting and health messaging documentation (fruit/vegetable consumption, sugar-sweetened beverage consumption, out-of-home food consumption, PA, and screen time) before and after MOC participation. Results: At baseline, pediatricians documented behavior-change goals with 44% of patients, with an additional 49% of patients having documented goals after their pediatrician started the MOC (99.5% confidence interval [CI]: 21–77%). Similarly, absolute increases in the proportion of patients with documentation for sugar-sweetened beverage consumption (adjusted prevalence difference [aPD]: 37%; 99.5% CI: 13–62%) and out-of-home eating were observed (aPD: 38%; 99.5% CI: 12–64%). Conclusion: The Healthy Weight Counseling MOC is associated with increased and sustained use of evidence-based health messages and counseling strategies. Practice implications: Continuing education and facilitation of system changes help improve physicians' weight-related counseling.