Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

McRae, Emily

Committee Member

Schirmer, Sarah

Author's Keywords

pediatric obesity prevention, childhood obesity, primary care, family practice, Maine Health, quality improvement


Background: In the United States today, nearly one third of children fall into the category of overweight or obese. Because it is extremely difficult to treat childhood obesity once it occurs, prevention is the optimal approach to childhood overweight and obesity (Brown & Perrin, 2018; Cooper & Mandel, 2020). An ideal time to address obesity prevention health behaviors is during pediatric primary care visits. Since the COVID-19 pandemic began in the United States in 2019, visits to primary care offices, including visits to an urban university-based family practice clinic in Kentucky, dropped as some pediatric patients and their caregivers worried they could be at risk for contracting COVID-19 by visiting a primary care office (O’Leary et al., 2021).

Purpose: The purpose of the project was to pilot an evidence-based obesity prevention intervention developed by Maine Health at the project site during both well-child and sick visits to ensure as many children as possible were provided with anticipatory guidance related to obesity prevention during both well-child and sick visits.

Intervention: Children two to 18 years of age and/or their caregivers were asked to fill out an obesity prevention healthy habits questionnaire (HHQ) prior to seeing their provider. The provider then discussed the results of the questionnaire with the patient and caregiver during their well or sick child visit, went over 5210 behavioral goals developed by the Maine Youth Overweight Collaborative (MYOC) during the visit, and the provider and child-caregiver dyad then collaborated to identify a health behavior goal related to obesity prevention. The provider then documented discussion of the child’s goal in the electronic health record (EHR) using a smart phrase that was created as a part of this quality improvement (QI) project.

Methods: The primary outcome evaluated through the obesity prevention intervention was documentation of health promotion related to obesity prevention in the EHR. Evaluation of documentation of key phrases and health behavior goals were evaluated pre and post intervention to measure improvement in promotion of obesity prevention health behaviors with the implementation of this obesity prevention intervention. Secondary outcomes measured included improved recognition and diagnosis of overweight (OW) and obesity (OB) in children, fidelity to the intervention, number of follow-up appointments generated as a result of the intervention, and the qualitative measurement of provider satisfaction with the intervention.

Keywords: pediatric obesity prevention, childhood obesity, primary care, family practice, Maine Health, quality improvement

Erin_Semeyn_signed_title_page.pdf (35 kB)
Signed title page