Managing Patient Expectations in Pediatric Weight Management

Overview

As part of Children's Hospital Association's Focus on a Fitter Future III Obesity Task Force, this project will target patient and family expectations across the domains of nutrition, physical activity and behavior change/family support as a means of patient engagement and retention in pediatric weight management. This will be a prospective, non-randomized, uncontrolled, single-arm trial for children between 2 and 18 years of age and a parent/guardian, who are starting a pediatric weight management program/clinic in one of the participating centers. The parent/guardian and child if 12 years of age or older receive a survey at the first visit, which asks about their expectations and goals for the visit. This information will then be used as part of clinical care to tailor treatment. After 3 months, the parent/guardian and adolescent, if applicable, will receive a follow up survey asking about their progress in these areas.

Full Title of Study: “Managing Expectations in Pediatric Weight Management: A Pilot Study in Focus on a Fitter Future III Hospitals”

Study Type

  • Study Type: Interventional
  • Study Design
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Health Services Research
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 2013

Interventions

  • Behavioral: Patient Expectations
    • Baseline Expectations survey (parent/guardian and adolescents 12 and older)
  • Behavioral: Patient Expectations
    • 3 month follow up survey (parent/guardian and adolescents 12 and older)

Arms, Groups and Cohorts

  • Experimental: Patient Expectations
    • At the family’s initial visit to the pediatric weight management program/clinic each parent/guardian and adolescent (if age 12 yrs. or older) will complete the survey tool. At 3 months, families will be asked to complete a follow up survey. This will be fielded at a visit for those returning to clinic or by phone/mail for those not returning.

Clinical Trial Outcome Measures

Primary Measures

  • Attrition at 3 months
    • Time Frame: 3 months
    • Defined for treatment clinics (i.e., no set end point) as attending an initial appointment but no further appointments in a 3 month period. For treatment programs (i.e., set end point), attrition is defined as attending <25% of visits in a 3 month period

Secondary Measures

  • Congruence of learning needs and achieved outcomes
    • Time Frame: 3 months
    • Defined as a match between the identified most important treatment expectation in each of the domains at baseline and the most helpful treatment domains at 3 months. Congruent = at least 4 out 6 possible matches.

Participating in This Clinical Trial

Inclusion Criteria

  • Subject conversant in English or Spanish
  • Parent/guardian conversant in English or Spanish
  • Patient aged 2-18 years

Exclusion Criteria (For Adolescent):

• Parent-reported cognitive issues preventing completion of the form, such as in-school aide>50% of the school day; special education classes >50% of school day

Gender Eligibility: All

Minimum Age: 2 Years

Maximum Age: 18 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Boston Children’s Hospital
  • Collaborator
    • University of Nebraska
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Erinn Rhodes, MD, MPH, Study Chair, Boston Children’s Hospital
    • Sarah Hampl, MD, Study Chair, Children’s Mercy Hospitals & Clinics

References

Hampl S, Demeule M, Eneli I, Frank M, Hawkins MJ, Kirk S, Morris P, Sallinen BJ, Santos M, Ward WL, Rhodes E. Parent perspectives on attrition from tertiary care pediatric weight management programs. Clin Pediatr (Phila). 2013 Jun;52(6):513-9. doi: 10.1177/0009922813482515. Epub 2013 Mar 28. Erratum in: Clin Pediatr (Phila). 2014 Mar;53(3):NP1.

Sallinen Gaffka BJ, Frank M, Hampl S, Santos M, Rhodes ET. Parents and pediatric weight management attrition: experiences and recommendations. Child Obes. 2013 Oct;9(5):409-17. doi: 10.1089/chi.2013.0069. Epub 2013 Sep 12.

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