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Implementing a Patient-Centered Pediatric Obesity Protocol in a Population With Social and Environmental Risk Factors
Implementing a Patient-Centered Pediatric Obesity Protocol in a Population With Social and Environmental Risk Factors
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103555
- ISBN
- 9798288807077
- DDC
- 610.73
- 저자명
- Walsh, Carolyn.
- 서명/저자
- Implementing a Patient-Centered Pediatric Obesity Protocol in a Population With Social and Environmental Risk Factors
- 발행사항
- [Sl] : Yale University, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 52 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-01, Section: B.
- 주기사항
- Advisor: Ordway, Monica.
- 학위논문주기
- Thesis (D.N.P.)--Yale University, 2025.
- 초록/해제
- 요약Children and adolescents exposed to adverse childhood experiences (ACEs) and negative social determinants of health (SDoH) have an increased risk of developing pediatric obesity. The American Academy of Pediatrics Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (2023) recommends assessing these factors in children with obesity. At a School-Based Health Center (SBHC), the standard of care for pediatric obesity did not include ACEs and SDoH screening, highlighting a gap in practice. This Doctor of Nursing Practice project developed, implemented, and evaluated a patient-centered pediatric obesity protocol incorporating ACEs, SDoH screening, and referrals to patient-centered medical home (PCMH) services during SBHC nutrition visits. A quality improvement design was used. The project was implemented in an urban K-8 SBHC. A chart review of 20 pre-implementation and 33 post-implementation visits for children aged 10-15 years was conducted. Fisher's exact test assessed changes in referral rates, and descriptive statistics evaluated acceptability, appropriateness, and feasibility. Post-implementation, 76% (n=25) of patients screened positive for at least one ACE or SDoH risk factor, compared to none pre-implementation. There was an increase in referrals to Nutrition (p0.05), Care Coordination (p=0.25), and Behavioral Health (p=0.33) Departments. Staff reported the protocol as acceptable, appropriate, and feasible. Findings suggest that implementing a site-specific, guideline-aligned protocol can effectively identify ACEs and SDoH risk factors associated with pediatric obesity and increase referrals to supportive services within a PCMH. Identifying these risks is crucial for comprehensive obesity care and for mitigating long-term obesity-related health outcomes in children.
- 일반주제명
- Nursing
- 일반주제명
- Pediatrics
- 키워드
- Obesity
- 기타저자
- Yale University Yale University School of Nursing
- 기본자료저록
- Dissertations Abstracts International. 87-01B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■0820 ▼a610.73
■1001 ▼aWalsh, Carolyn.
■24510▼aImplementing a Patient-Centered Pediatric Obesity Protocol in a Population With Social and Environmental Risk Factors
■260 ▼a[Sl]▼bYale University▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a52 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-01, Section: B.
■500 ▼aAdvisor: Ordway, Monica.
■5021 ▼aThesis (D.N.P.)--Yale University, 2025.
■520 ▼aChildren and adolescents exposed to adverse childhood experiences (ACEs) and negative social determinants of health (SDoH) have an increased risk of developing pediatric obesity. The American Academy of Pediatrics Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (2023) recommends assessing these factors in children with obesity. At a School-Based Health Center (SBHC), the standard of care for pediatric obesity did not include ACEs and SDoH screening, highlighting a gap in practice. This Doctor of Nursing Practice project developed, implemented, and evaluated a patient-centered pediatric obesity protocol incorporating ACEs, SDoH screening, and referrals to patient-centered medical home (PCMH) services during SBHC nutrition visits. A quality improvement design was used. The project was implemented in an urban K-8 SBHC. A chart review of 20 pre-implementation and 33 post-implementation visits for children aged 10-15 years was conducted. Fisher's exact test assessed changes in referral rates, and descriptive statistics evaluated acceptability, appropriateness, and feasibility. Post-implementation, 76% (n=25) of patients screened positive for at least one ACE or SDoH risk factor, compared to none pre-implementation. There was an increase in referrals to Nutrition (p0.05), Care Coordination (p=0.25), and Behavioral Health (p=0.33) Departments. Staff reported the protocol as acceptable, appropriate, and feasible. Findings suggest that implementing a site-specific, guideline-aligned protocol can effectively identify ACEs and SDoH risk factors associated with pediatric obesity and increase referrals to supportive services within a PCMH. Identifying these risks is crucial for comprehensive obesity care and for mitigating long-term obesity-related health outcomes in children.
■590 ▼aSchool code: 0265.
■650 4▼aNursing
■650 4▼aPediatrics
■653 ▼aAdverse childhood experiences
■653 ▼aSocial determinants of health
■653 ▼aSchool-Based Health Center
■653 ▼aPatient-centered medical home
■653 ▼aObesity
■690 ▼a0569
■690 ▼a0767
■690 ▼a0769
■71020▼aYale University▼bYale University School of Nursing.
■7730 ▼tDissertations Abstracts International▼g87-01B.
■790 ▼a0265
■791 ▼aD.N.P.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357751▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
