12-month program helps Rhode Island pediatricians navigate rising rates of child obesity

  • 14 Dec 2023

As Rhode Island continues to face a mounting primary care workforce shortage, the state’s Care Transformation Collaborative of RI (CTC-RI) is working to pilot and advance programs that respond to the growing needs of the practicing primary care workforce. One of those needs expressed by pediatricians statewide is help navigating the difficult topic of weight management, with more Rhode Island children experiencing an increase in overweight and obesity since the onset of the pandemic.

This fall, CTC-RI completed its first 12-month pediatric weight management pilot program, funded by Point32Health, the parent company of Tufts Health Plan and Harvard Pilgrim Health Care, in response to that need. The “Pediatric Weight Management ECHO” helped practices become better equipped to intervene and positively impact children with weight management concerns. Project ECHO (Extension for Community Healthcare Outcomes) is a collaborative model of medical education and case reviews that helps clinicians provide expert-level care to patients. 

“We saw an opportunity to figure out how to improve care for children who are overweight or obese by taking a behavioral health approach to behavior change. We found tremendous success by bringing different pediatric practices together to problem solve similar challenges, brainstorm ideas, share case studies, and engage in a focused learning curriculum over the last 12 months,” said Debra Hurwitz, MBA, BSN, RN, CTC-RI Executive Director. “Thanks to funding provided by Point32Health, we studied what happened when we connected pediatric care teams with behavioral health providers right on-site in their practices, and complimented that with focused learning around this sensitive topic. The results were impressive – not only did pediatricians and care teams feel more confident navigating this topic with patients, but results show that families were satisfied, felt respected, and were more comfortable openly discussing the weight of their children.”

The 12-month Pediatric Weight Management ECHO empowered seven primary care practices across the state with new skills, knowledge, and comfort to address this delicate topic with patients and their families. Participating practices included Anchor Pediatrics (Lincoln), Atlantic Pediatrics (Cranston), Santiago Medical Group (North Providence and Pawtucket), St. Joseph Health Center (Providence), Tri-County Community Action Agency (Johnston, North Providence, and Wakefield), Waterman Pediatrics – Coastal Medicine (East Providence) and Westerly Medical Center (Westerly).

“We joined this awesome collaborative to enhance the way we approach weight management in our practice. By learning from local experts and engaging in group discussion, we gain insight on innovative ways to work together with our patients when tackling this difficult topic,” said Jon Dooley, MD FAAP, a pediatrician at St. Joseph Health Center - Pediatric Clinic, who participated in the 12-month program. “Talking about weight is never fun… it’s easy for our patients to feel judged or uncomfortable. Making a connection and letting your patients know they are not alone (instead of just lecturing them) helps to empower more change and increases the chances of continued engagement.”

“We know how important it is for patients to not only trust their primary care doctors and care teams, but feel comfortable discussing sensitive health topics, and leave feeling empowered and supported by their conversations and care. CTC-RI’s Pediatric Weight Management ECHO is a great example of ways to invest in strategies and resources that respond to the real needs of our primary care workforce – helping them better help their patients,” said Glenn Pomerantz, MD, JD, Chief Medical Officer at Point32Health. “This year-long learning program embraced collaboration, provided motivational interviewing techniques that led to more engaging conversations with families, and ultimately, better health outcomes for children. Point32Health is proud to invest in programs that improve the health and wellness of Rhode Islanders.”

“Our behavioral health focus provided practice participants with new ways of understanding and approaching behavior change with their patients,” said Liz Cantor, PhD, practice and ECHO facilitator. “We were thrilled to be able to bring many of RI’s behavioral health research and clinical experts on childhood obesity and overweight into this Learning Collaborative to share information and teach best practice skills for increasing patient engagement and motivation.”  

Practices that participated in the learning program joined monthly learning sessions on topics ranging from cultural considerations to impacts on mental health to empowering parents, completed pre- and post-program assessments that measured impact, received practice facilitation support, and more. As CTC-RI’s pediatric weight management ECHO concluded, the organization launched a new ECHO program in September focused on supporting children and adolescents with restrictive eating disorders.

Link to official press release