Evaluation of a Childhood Obesity Screening Program in a Pediatric Dental Clinic

Abstract

Childhood obesity is a major public health concern in the United States. According to the CDC, nearly 24 million children and adolescents are overweight or obese. The prevalence of childhood obesity has increased considerably over the past two decades and continues to be a major health concern. Screening only by medical primary care providers is no longer a practical strategy. Healthy People 2020 asserted that disease prevention must be a shared priority and collaboration is necessary to curb this epidemic. Children between the ages of 6 to 12 are more likely to see their dentist than their primary care provider. Therefore, dentists are in an excellent and unique position to conduct BMI screening, and recommend follow-up with primary care providers of children identified as overweight or obese. Purpose: The purpose of this project was to implement and evaluate the effectiveness of a childhood obesity screening program for a pediatric dental clinic. Design: A process improvement project utilizing Rogers’ Diffusion of Innovation Theory as a framework to assess whether an educational intervention, identification and documentation of BMI-for-age screening in the electronic health record, and use of supportive tools such as an electronic scale and BMI-for-age growth chart improved engagement of dental students in screening for childhood obesity. Sample: A convenience sample of 12 fourth-year dental students in a pediatric dental satellite clinic participated in the program. Method: Utilizing paired-samples t-test, in a pre- and post-survey comparison design, the project determined if a childhood obesity screening program improved knowledge, attitudes, and beliefs of 12 fourth-year dental students. After completion of the educational intervention, CHILDHOOD OBESITY 3 documentation of BMI measurements, and recommendation to follow-up with primary care provider were assessed. Results: Six of the ten survey questions assessing knowledge, attitudes, and beliefs demonstrated statistically significant increase between pre- and post-survey scores. There was no difference in four of the ten survey questions. Of the 42 children who were seen during the study, 23 (55%) had BMI screening performed. Ten (43%) of the screened patients were identified as overweight or obese. Of the ten identified as overweight or obese, zero were recommended to follow-up with primary care provider. Implications: The role of the Doctor of Nursing Practice (DNP) leader is to synthesize the evidence and implement evidence-based guidelines. This process improvement project demonstrated that implementation of a childhood obesity screening program in a dental clinic has the potential to improve health outcomes and decrease health care costs. A future BMI screening program could be replicated in not only teaching dental clinics, but also private or community dental clinics.