2.50
Hdl Handle:
http://hdl.handle.net/10755/157505
Type:
Presentation
Title:
OUTCOMES IN A SCHOOL-BASED HEALTH CENTER
Abstract:
OUTCOMES IN A SCHOOL-BASED HEALTH CENTER
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Gance-Cleveland, Bonnie, PhD, RNC, PNP, FAAN
P.I. Institution Name:Arizona State University
Title:Director, Center for Improving Health Outcomes in Children, Teens & Families
Contact Address:500 North 3rd Street, Mailcode 3020, Phoenix, AZ, 85005, USA
Co-Authors:Kevin Gilbert; Taynin Kopanos; Lynn Howe Gilbert
PURPOSE: The purpose of the study was evaluation of the impact of technology for identifying and assessing children at-risk for obesity-related chronic illnesses in a school-based health center (SBHC).
BACKGROUND: The current obesity epidemic has produced a generation of children that maybe the first to have a life expectancy shorter than their parents. Computer decision support shows promise for supporting providers in identification and assessment of risk factors in children. The Chronic Care Model which includes technology support and continuous quality improvement provides a guiding framework for the study.
Design and METHODS: A pre-test/post-test design was used to evaluate documentation after the introduction of HeartSmartKids, a decision-support tool that integrates patient health information with evidence-based guidelines and generates graphic trends of cardiovascular risks and tailored recommendations. A random sample of 15% of clinic charts (every 8th chart) was audited prior to and after the introduction of the technology to evaluate the documentation of BMI, BMI percentile, BP, and BP percentile.
RESULTS: The 2006 chart review (n=101; ages 3-19.5 years, none 8.25 years) was 45% female. The 2008 chart review (n= 100; ages 3-18 years, none 9.8 years) was 44% female. Using Chi Square analysis there were significant differences in the documentation of BMI (p < .001) and BMI percentile (p < .001), which requires calculation and graphing the value for age and sex, after the introduction of technology assistance, going from 31% to 76%. Documentation of BP also significantly improved (p < .001) from 83% to 97%. Documentation of BP percentile, which requires comparing the BP for age, sex, and height to established cut points, showed significant improvement (p < .001) from 1% to 35%.
PRACTICE IMPLICATIONS:
Reversing the obesity epidemic requires immediate action to identify and assess children for obesity and cardiovascular risk factors. The findings from this study suggest the use of bilingual decision support technology greatly improves the identification and assessment of these at-risk children. By gathering and processing information and providing the patient with a tailored, evidence-based recommendation for lifestyle changes, the technology allows providers to promote behavior change to reverse this catastrophic trend toward shortened life expectancy.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleOUTCOMES IN A SCHOOL-BASED HEALTH CENTERen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157505-
dc.description.abstract<table><tr><td colspan="2" class="item-title">OUTCOMES IN A SCHOOL-BASED HEALTH CENTER</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gance-Cleveland, Bonnie, PhD, RNC, PNP, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Arizona State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director, Center for Improving Health Outcomes in Children, Teens &amp; Families</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">500 North 3rd Street, Mailcode 3020, Phoenix, AZ, 85005, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Bonnie.Gance-Cleveland@asu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kevin Gilbert; Taynin Kopanos; Lynn Howe Gilbert</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: The purpose of the study was evaluation of the impact of technology for identifying and assessing children at-risk for obesity-related chronic illnesses in a school-based health center (SBHC). <br/>BACKGROUND: The current obesity epidemic has produced a generation of children that maybe the first to have a life expectancy shorter than their parents. Computer decision support shows promise for supporting providers in identification and assessment of risk factors in children. The Chronic Care Model which includes technology support and continuous quality improvement provides a guiding framework for the study. <br/>Design and METHODS: A pre-test/post-test design was used to evaluate documentation after the introduction of HeartSmartKids, a decision-support tool that integrates patient health information with evidence-based guidelines and generates graphic trends of cardiovascular risks and tailored recommendations. A random sample of 15% of clinic charts (every 8th chart) was audited prior to and after the introduction of the technology to evaluate the documentation of BMI, BMI percentile, BP, and BP percentile. <br/>RESULTS: The 2006 chart review (n=101; ages 3-19.5 years, none 8.25 years) was 45% female. The 2008 chart review (n= 100; ages 3-18 years, none 9.8 years) was 44% female. Using Chi Square analysis there were significant differences in the documentation of BMI (p &lt; .001) and BMI percentile (p &lt; .001), which requires calculation and graphing the value for age and sex, after the introduction of technology assistance, going from 31% to 76%. Documentation of BP also significantly improved (p &lt; .001) from 83% to 97%. Documentation of BP percentile, which requires comparing the BP for age, sex, and height to established cut points, showed significant improvement (p &lt; .001) from 1% to 35%. <br/>PRACTICE IMPLICATIONS: <br/>Reversing the obesity epidemic requires immediate action to identify and assess children for obesity and cardiovascular risk factors. The findings from this study suggest the use of bilingual decision support technology greatly improves the identification and assessment of these at-risk children. By gathering and processing information and providing the patient with a tailored, evidence-based recommendation for lifestyle changes, the technology allows providers to promote behavior change to reverse this catastrophic trend toward shortened life expectancy. <br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:56:02Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:56:02Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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