404 - Qualitative Analysis of Clinician Experiences after a Quality Improvement Project Focused on Empathetic Management of Obesity in Pediatric Primary Care

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 404
Publication Number: 404.146

Elizabeth Taliaferro, Children's National Health System, Washington, DC, United States; Alicia Tucker, Children's National Health System, Alexandria, VA, United States; Kofi Essel, Children's National Health System, Washington, DC, United States

Presenting Author(s)

Erynn Richards (she/her/hers)

Research Assistant
Children's National Hospital

Co-Author(s)

ET

Elizabeth Taliaferro, MD (they/them/theirs)

Pediatric Resident
Children's National Health System
Washington, District of Columbia, United States

Background: Obesity and weight-related chronic disease are increasingly common among youth, with approximately 20% of youth impacted. Current best practice guidelines indicate that primary care pediatricians should support both prevention and management of obesity avoiding stigma towards patients and families. However, primary care pediatricians face several different barriers to filling this role.

Objective:

The primary objective of this project was to explore provider experiences status post a Quality Improvement project designed to decrease barriers to management of obesity in the primary care setting.

Design/Methods: Post-intervention interviews were conducted with providers who participated in a QI initiative at two Children’s National Hospital primary care sites that ran from March 2021- March 2022. The QI project included monthly educational sessions by subspecialists, clinical algorithms, online resources, and mini coaching sessions during monthly staff meetings to provide feedback. 17 providers participated in the QI project. After the conclusion of the project, individual interviews were conducted to assess provider experience with the QI project. The interviews were transcribed, and preliminary analysis completed, and themes developed.

Results: 15 pediatric providers completed the post-intervention interview. Four preliminary primary themes were identified regarding provider lived experiences after the intervention. 1) Streamlining of information unified provider practices and decreased mental load, 2) Increased provider comfort with management and referral steps, especially lab work, 3) Increased provider awareness of potentially stigmatizing language and attempts to change language, 4) Time constraints persist as a barrier to managing obesity in primary care.

Conclusion(s): Overall, pediatric providers felt that the QI project improved both individual and collective management of obesity and diet-related chronic disease in the primary care setting. While the project was unable to address the largest barrier- time constraints- providers almost universally perceived that the project had improved their management of obesity in the primary care setting.