UCLA is taking an active role in the fight against childhood obesity. Their latest endeavor was announced on December 9 at the Southern California Public Health Association Conference. The UCLA researchers developed a pilot program that uses telehealth technology, which is a secure system that allows patients to see and speak with their UCLA healthcare providers with the use of a computer at their local health clinic. The pilot program was initiated to determine whether such a system could be an effective strategy to help combat childhood obesity.
The UCLA healthcare professionals who deal with childhood obesity suggest that a multidisciplinary approach (care provided by a variety of specialists) can benefit children dealing with the issue who need extra help losing weight. However, the logistics of traveling to multiple appointments, even if just across town, can impact the delivery of healthcare, particularly for low-income families. An analysis of the telehealth program found that the vast majority of pediatric patients (approximately 80%) were satisfied with their telehealth appointment; they noted that it was similar to a personal conversation with the doctor and that it was easier to go to the local clinic than to the UCLA campus in Westwood; in addition, they felt that their privacy was protected. Furthermore, 80% said they would participate in a telehealth appointment again. A similar rate of positive responses was found among the healthcare providers.
“One surprise was how natural it was to talk with each other through the telehealth system, even though we never met the patients in person,” noted lead author Dr. Wendy Slusser, medical director of the Fit for Healthy Weight program at Mattel Children’s Hospital UCLA and director of pediatric wellness programs at the Venice Family Clinic. She added, “The interaction was very much like being in the same room together. Some kids even thought it was fun to see themselves on the screen.”
The researchers with the Fit for Healthy Weight program collaborated with UCLA colleagues, the Venice Family Clinic, and the Los Angeles Unified School District to develop a telehealth system that met a high standard of encryption and was compliant with national regulations to ensure patient privacy. The study group comprised 45 children (average age: 10 years); they visited their regular local clinic, either the Venice Family Clinic’s Simms/Mann Health and Wellness Center in Santa Monica, or the LAUSD’s San Miguel Healthy Start Clinic in South Gate. At their local clinic, the children and their parents checked in with an on-site medical assistant and a primary care physician who took their vital signs, including height, weight, and blood pressure; laboratory studies were also done at the clinic. The patient and a parent then sat in front of a telehealth computer and talked face-to-face with specialists from the UCLA Fit for Healthy Weight clinic who were located at the 200 UCLA Medical Plaza building in Westwood. The healthcare professionals included a pediatrician, a psychologist, and/or a dietitian.
During the telehealth appointment, the UCLA providers reviewed the patients’ vitals and laboratory results, asked questions about the patient’s health and lifestyle, and worked with the family to set healthy lifestyle goals and addressed the patient’s health issues. To evaluate the effectiveness of the program, satisfaction questionnaires were given to both the young patients (or to the parent if a child was too young) and the primary care providers at the local clinic after the telehealth appointment. The investigators also reviewed patient charts to determine how their body mass index (BMI) evolved; they tracked BMI before, during, and a few months after their appointment.
The patients were almost equally divided in gender (52% male; 48% female); the average baseline BMI was in the 98th percentile. Over time, 86% of the 25 patients who were followed after their telehealth appointments either stabilized or decreased their BMI scores, and three of the four patients with high blood pressure normalized their blood pressure. The researchers note that the other positive outcome was the relative ease with which the Fit for Healthy Weight program was able to implement and adapt the technology. “Although there were a few technological challenges in the beginning, we learned some valuable lessons in implementing a telehealth program,” noted Margaret Whitley, project manager of the Fit for Healthy Weight program.
The next phase of this project is a pilot home telehealth program, which will allow patients to talk to their doctor from home. This will eliminate the need for patients to travel to a local clinic, which can be especially beneficial for patients with mobility limitations. In addition, researchers are also helping the LAUSD develop a “teledietitian” project. “Pediatric obesity is a serious epidemic that can lead to long-lasting health problems as children grow into adulthood,” Dr. Slusser said. She added, “We urgently need to find new ways to overcome barriers, and telehealth is a promising tool.”