Improving Pediatric Obesity Practice Using Prompts (iPOP-UP): Using Electronic Health Records to Support Decision-Making in Pediatric Obesity Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 140
- 试验地点
- 1
- 主要终点
- Change in proportion of patients with obesity
研究概览
简要总结
This study compares the effectiveness of electronic health record (EHR)-based tools to support the management of pediatric obesity in primary care. All clinicians will receive an interruptive "pop-up" alert We will examine the impact -- the added value versus unintended consequences -- of the interruptive alert on the quality of obesity management in pediatric primary care.
详细描述
The primary specific aims of this study are to:
- To assess the impact of EHR-based tools for pediatric obesity in primary care. Hypotheses: EHR-based clinical decision support tools that interrupt but support clinical workflow will (1) improve measures of pediatric obesity care quality delivered by clinicians (e.g., addition of obesity to the problem list, recommended screening for comorbidities, and follow-up/referral plans) and (2) result in a reduced rate of BMI increase over one year among children with obesity.
- To utilize a mixed methods approach with surveys and semi-structured qualitative interviews with clinicians to (1) examine the extent to which the EHR tools positively impact clinicians' awareness, knowledge and adherence to expert guidelines for pediatric obesity management, and (2) to explore the barriers to and facilitators of clinicians' use of the EHR tools and factors that influence adoption.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All pediatric primary care providers providing well child care for patients ages 2-17 years-old in the Boston Children's Hospital primary care practices will be eligible for the study. There are no
排除标准
- 未提供
研究组 & 干预措施
Interruptive Clinical Decision Support
干预措施: Interruptive Clinical Decision Support (Behavioral)
结局指标
主要结局
Change in proportion of patients with obesity
时间窗: 1-year pre-implementation compared to 1-year post-implementation
Change in proportion of patients with obesity who receive age-appropriate screening for comorbidities (blood measure measurement and age-appropriate laboratory screening)
Change in proportion of patients with obesity who have counseling for obesity-related behavior change documented in the EHR
时间窗: 1-year pre-implementation compared to 1-year post-implementation
Change in body mass index (BMI)
时间窗: 1 year pre-intervention, baseline, and 1 year post-intervention
change in BMI, calculated from height and weight measured as part of routine clinical practice during primary care clinic visits and documented in the EHR
Change in percent BMI above the 95th percentile (%BMIp95)
时间窗: 1 year pre-intervention, baseline, and 1 year post-intervention
Change in percentage of age/sex-adjusted BMI above the 95th percentile (%BMIp95), calculated from height and weight measured as part of routine clinical practice during primary care clinic visits and documented in the EHR
Change in documentation of elevated BMI diagnosis
时间窗: 1-year pre-implementation compared to 1-year post-implementation
Change in proportion of patients with obesity who have elevated BMI documented in the EHR
Change in proportion of patients with obesity with follow-up or referral orders
时间窗: 1-year pre-implementation compared to 1-year post-implementation
次要结局
- Change in provider knowledge, attitudes and practice around obesity management in primary care assessed via an electronic surveys and qualitative interviews of clinicians(baseline compared to 6 months post-implementation)
- System usability scale (SUS) score(6 months post-implementation)