TABLE 1.
Types of Interventions to Improve Primary Care Obesity Practice and Representative Examples.
| Type of Educational Tool/Strategy | Relative Intensity | Relative Cost | Effectiveness at Practice Change | Example |
|---|---|---|---|---|
| Multiday, multisite practice-change collaborative model with instruction in quality-improvement methods | High | High | Evidence of large change in practice maintained long-term | Washington State Steps to Health, King County and Maine Youth Overweight Collaborative10,13 |
| Breakthrough-series collaborative plus electronic medical record distribution with integrated obesity decision support | High | High | A large-scale intervention was effective in changing practice, but there were challenges with implementation | Nemours (Wilmington, DE)30 |
| One-day trainings with follow-up visits (academic detailing or booster training) | Moderate | Moderate | Low effectiveness without follow-up per Cochrane reviews; moderately effective with follow-up | Envision New Mexico school-based health centers12 |
| Webinars/calls on topics of interest | Low to moderate | Low to moderate | Evidence not available | NICHQ-COAN Q-calls (www.nichq.org/conferences_training/q-calls/index.html |
| Internet listing of collected resources | Low | Low | Evidence not available | NICHQ childhood obesity implementation guide: best practices and tools (www.nichq.org) |
| Internet-based distribution of a comprehensive toolkit for providers plus Internet-based quality improvement | Low | Moderate (to develop toolkit) | Evidence not available; the AAP Web site will allow individual practice to compare results with a national reference database | AAP “Let's Move in the Clinic” (www.aap.org/obesity/letsmove) |
| Internet-based interactive training | Low | Moderate (to develop training) | Evidence not available | Kaiser Permanente online tutorial in motivational interviewing (www.kphealtheducation.org/pwm) |
| Traditional didactic CME lectures | Low | Low | Evidence of small effect for multiple conditions | Cochrane reviews26 |
NICHQ-COAN indicates National Initiative for Children's Healthcare Quality Childhood Obesity Action Network; AAP, American Academy of Pediatrics.