Childhood obesity has now become an epidemic among young people and it is estimated to increase over 10% by 2020. Oregon is currently ranked 14th in the nation for childhood obesity. In 2009, there were combined 26.7% of Oregon children who were considered either overweight or obese. Currently there is no consistency among providers on how to treat and counsel this increasing epidemic which is at its worse in the rural communities. There is a greater need of organizational change since this clinic is in rural Oregon and the availability to refer patients out to specialist and/or nutritionist is increasingly difficult. Counseling on diet and exercise rests on providers during well-child exams, thus having an educational brochure to facilitate discussion increases provider/patient relationship and knowledge. The health promotions model by Pender guided was used to guide the study and incorporates couseling of diet and exercise as it encourages patients to be an active participant in their own health promotion. Stevens Star Model of Knowledge Transformational learning is evident using the educational brochure to provide knowledge that is then applied. Objectives of this project was to assess the effectiveness of the implementation of a brochure on the Traffic Light Diet (TLD) with children who are at the 80% of higher of body mass index in a rural pediatric office in Eastern Oregon. TLD has been shown to be an effective way to teach both children and adults on a lifestyle of eating and implementing the brochure was effective. The goal was to increase the consistency and conversation between provider and patients/parents on the treatment of obesity. Perceived change was the consistency in the care of those pediatric patients who BMI is at or above the 80%. The Quality Improvement Manager (QIM), used date from the Electronic Health Record (EHR) by documenting specific ICD-10 codes after counseling, documentation and discussion was achieved. Following the educational intervention, 14 of 27 charts had documentation of discussion and distribution of the TLD brochure. While the percentage documentation rate is lower than published literature, extending the time frame of the project may yield higher documentation. The low number of charts reviewed may be related to fewer providers conducting WCC during the project. Recommendations are to encourage medical assistants (MA) to attach the educational brochure to the superbill as a reminder to providers to discuss and distribute the TLD. Additionally, increasing the age range in which the project was initially completed to ensure more children are educated on the importance of diet and exercise. Changing incidence of childhood obesity through one patient, one child, and one change at a time.
