O1129: Implementing a Virtual Pediatric and Adolescent Healthy Lifestyle Program Through a Quality Improvement Project

Purpose/Objectives: Group web-based interactive interventions can play a role in addressing the obesity crisis in children. Through a Quality Improvement Model, we aimed to establish a virtual Healthy Lifestyle Program (HLP) for patients ages 8 to 17 with a target of 60% weekly attendance rate at each virtual group session by June 2022.

Design/Methods: We created an “Obesity BMI Core Group” and met regularly to design a virtual HLP consisting of nutrition and exercise components using the Choose Health: Food, Fun, and Fitness curriculum, created by the Cornell Cooperative Extension (CHFF). CHFFF is a six-lesson curriculum for children and adolescents that teaches healthy eating and active play.
We use the IHI model of improvement using aim statements and measures followed by PDSA cycles. Our outcome measure was attendance rate at each session. We identified key drivers affecting retention: patient/family and provider awareness, time, and clinical integration process. We conducted PDSA cycles for each cohort to discern the factors that would most affect our outcome measure.

Results: We completed a total of three virtual cohorts from August 2021 to April 2022 on Monday afternoons in two groups: ages 8-11 and ages 12-17. We enrolled a total of 73 participants (1st cohort n=19; second cohort n=27; third cohort n=27). The attendance rate for the first cohort was 54% for the younger group and 50% for the older group. From our first PDSA, we discovered the following barriers: difficulties accessing Webex. For the second cohort, we adjusted the times to prevent conflict with school/after-school activities. We also created a tip sheet with visual cues on how to access the Webex. At the end of the second cohort, the attendance rate for the younger group was 44% and 31% for the older group. For our last PDSA, we implemented reminder calls/texts to participants 30 minutes prior to the session and changed the first meeting to be in person to increase acceptance. At the end of the third cohort, the attendance rate for the younger group was 64% and 76% for the older group, a rate above the median and goal of 60% for the combined group.

Conclusion/Discussion: Group web-based interactive programs allow for delivering information to large groups. This system increased access to care at a low or no cost, no travel requirements and reduced time commitment. Challenges related to technical difficulties and competing priorities can be overcome by sharing visual instructions for using the web platform and completing reminder calls/messages thirty minutes before sessions.