P2.J188: Healthy Living Visits: Implementing the Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity in Primary Care

Purpose/Objectives: The Healthy Living Visits quality improvement project aims to operationalize the AAP Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity in the primary care setting through increased clinician training, expansion of programs and services for patients, and engaging a multidisciplinary team.

Design/Methods: Participating pediatricians from sites across Children’s Primary Care Medical Group (CPCMG), a 28-site pediatrics single-specialty group, receive training to optimize the primary care management of obesity. Training sessions include an overview of the clinical practice guidelines, focused training on the growth chart and how to talk about weight, basics of motivational interviewing, comorbidities evaluation and management, coding and billing and specific content to deliver the Healthy Living Visits curriculum of 6 monthly 20-minute theme-based coaching sessions, to be delivered either in person or through video visit, addressing nutrition, physical activity, screen use, sleep, and social/emotional wellness for children with overweight or obesity. Participating clinicians are offered optional anti-obesity medication training. Clinicians may refer any Healthy Living Visit patients for additional video, phone, or MyChart-message-based health coaching with a health coach and access to robust online patient resources. Clinicians also have access to a more intensive specialty clinic for obesity including intensive health behavioral lifestyle treatment and anti-obesity medication prescribing (WELL Clinic), a virtual teaching kitchen, and mindfulness sessions, all available through CPCMG. The Healthy Living Visits materials are incorporated into an Epic Smartset. Participating clinicians are approved to receive 25 points of MOC-4 credit.

Results: Thirty seven clinicians at 20 sites are enrolled in the Healthy Living Visits training program. Visit numbers, MOC-4 completion, percentage of patients with Med-Cal insurance, clinician confidence in the treatment of childhood obesity, and medication prescribing and insurance approvals and denials are being monitored over the course the of year-long program.

Conclusion/Discussion: This MOC-4 approved obesity management program offers an approach to implement the Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity in the primary care setting by (1) increasing clinician knowledge and competence in the guidelines, medication prescribing, and healthy living principles and behavioral modification, and (2) offering access to health coaching, robust online resources, and a defined curriculum.