NURS5097 Primary Health Care - Intervention to Reduce Health Inequalities - Assignment Help

Elsie M Traveras et al, 2011. The High Five for Kids Study, Improve Primary Care to Prevent and Manage Childhood Obesity: Randomized Controlled Trial

The following intervention was aimed to develop primary care to inhibit and manage obesity among preschool children in United States. The chosen children were 2-6 years old, overweight and obese. Their body mass index was more than 95th percentile or between 85th to 95th percentiles, when calculated as, weight in kilograms divided by height in meters squared (Taveras et al., 2011). The core focus was maintained on children whose parents were overweight because the probability to become obese in adulthood increases for such children and can also lead to other complications. Additionally, the chosen children also received pediatric care at Harvard Vanguard Medical Associates between August 2006 and October 2008. This intervention was divided into two elements community and health system. The main element for this intervention was to change health care system by trained members, who entered this trial to play active role in the intervention. 

According to Taveras et al. (2011) the population for this trial has selected randomly from 10 primary care pediatric office of Harvard Vanguard Medical Associate. In the beginning the population was 3253 children whose (BMI) was 85th percentile or more, during a year in well-child-care visit. Before one month of well child care visit, pediatric providers have sent an email to each family, containing information of the study and opt-out telephone number, so that parents can inform about their willingness to take part in the study. In addition, pediatric provider telephoned families who did not contacted within 7days after email has been sent.  The children were excluded from trial for different reasons, such as; parents who have difficulty to respond in English and Spanish language, families who decided to leave Harvard Vanguard Medical Associate, children who have chronic medical condition, families who thought that the intervention will not be appropriate, children who are older than 6 years, children whose parents were not overweight and the families that the providers cannot contact with. Finally, the number of children who enrolled in this trial were 475, of which 204 children participant were in usual care and 271 were in intervention. From these participants, 192 participants in usual care (94% of those enrolled) and 253 participants in intervention (93% of those enrolled) completed one year telephone interview and well-child care visit for (BMI) measurement (Taveras et al., 2011). 

Participants who were involved in usual care, received care by paediatric care providers that consisted of well-child-care-visit and follow-up appointment to observe children weight by paediatrician and family visits (Taveras, et al, 2011).  Intervention focused on changing health care system by two mean. Firstly, by improving electronic medical record to help clinicians with decision support, patient tracking, follow-up, scheduling and billing. Secondly, by encouraging trained paediatric nurse to become the essential intervening through use of motivational interviewing, during chronic disease management visits and through telephone calls, during first year of intervention. In this visit they improved educational modules, targeting the hours of television viewing per day and fast food and sugar-sweetened beverage intake. Additionally, printed and electronic tools for self-management support were also used with lists of local re-sources for physical activity.