An article from researchers at Drexel University on “Improving Processes of Care for Overweight and Obese Children, using Evidence from the 215-GO! Program in Philadelphia Health Centers”, asserts that the 215-GO! program improved most processes of care but did not translate into improved body mass index outcomes for all patients. Clinic-based treatment of childhood overweight and obesity continues to fail to meet the burden of that condition.
The article appeared in the May/June 2014 issue of ASPPH’s Public Health Reports and was authored by Mr. Daniel M. Walker, ’11 alumni (now a doctoral student at Tulane School of Public Health and Tropical Medicine), Dr. Jessica M. Robbins, adjunct professor in the department of epidemiology and biostatistics, Dr. Darryl Brown, assistant professor in the department of health management and policy, and Dr. Zekarias Berhane, who provided statistical guidance.
The 215-GO! program, developed in 2004 in response to issues concerning childhood overweight and obesity, represents an interdisciplinary approach to treating the disease. 215-GO! is an acronym: 2=limit screen time to <2 hours a day; 1+include a minimum of one hour per day of physical activity; 5= eat five servings of fruit and vegetables per day; G=great; and O = opportunities. The program ran in four of the Philadelphia Department of Public Health operated health centers that provide care without regard to ability to pay and serve predominantly low income and minority populations.
According to this article, children are referred to the program staff by their pediatricians, and the health center team develops a coordinated treatment plan, providing comprehensive disease management between a child’s physician and an on-site nutritionist and health educator.
Pediatric patients aged 3-18 who had a well-child visit at any of the health centers and a BMI >85 percentile rank and a follow-up visit at least six months after the initial visit were eligible for this study.
The authors of this study point out that childhood overweight and obesity has reached epidemic proportions in the U.S., yet there is a dearth of evidence for effective clinic-based programs to both identify and treat the condition. The study provides an alternative model that promotes improved processes of care in an urban setting. However, the 215-GO! program remains insufficient on its own to reduce BMI for all children. Improvements in processes of care are necessary to begin to identify and develop treatment protocols for overweight and obesity.