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Study: Telemedicine Can Help Rural Doctors Manage Childhood Obesity

Ulfat Shaikh 032.jpg

Participation in an online learning network can help rural physicians improve their adherence to childhood-obesity-prevention guidelines, according to a study published online yesterday in the American Journal of Medical Quality. 

For the study, researchers from the University of California, Davis examined seven primary care clinics in rural California that participated in the Healthy Eating Active Living TeleHealth Community of Practice (HEALTH COP). The clinics participated in the virtual HEALTH COP program for nine months to learn best practices regarding childhood-obesity prevention and share such practices with their colleagues.

As covered extensively by my colleague Diette Courrégé Casey on our Rural Education blog, rural communities often face unique challenges due to their geographical situations. Health care clinics are often fewer and farther between in rural areas, and rural children are more likely to be overweight compared to their urban peers, according to previous research. A study published earlier this year also found more than half the U.S. regions with a doctor shortage are rural, Diette reported.

With that in mind, the UC Davis researchers created the HEALTH COP network in an effort to improve childhood-obesity prevention through evidence-based practices.

"As an urban pediatrician, if I can't figure out a problem, all I have to do is find a colleague in the building and get their impressions," said Ulfat Shaikh, the study's lead researcher and the director of Healthcare Quality at the UC Davis School of Medicine, in a statement. "By setting up this network, we made it easier for rural clinicians to do the same. Regardless of where they were in California, they all face similar problems. Now they can share solutions."

Well and Good

A total of 144 children participated in the study by visiting one of the health care clinics two separate times: once between April and June of 2010 (before the HEALTH COP initiative began) and once between January and May of 2011 (after the HEALTH COP initiative began). The clinicians who participated in the program learned general pediatric obesity facts through videoconferencing and a set of online resources.  

On average, clinicians who partook in the program discussed more topics regarding pediatric obesity with families after the intervention than before. The researchers noted a "significant" increase in counseling on sugary drinks and video games, and non-statistically significant increases in counseling on fruits and vegetables, breakfast, and family meals.

Children who received care by clinicians who participated in HEALTH COP also reported positive gains in both nutrition and physical activity, the study found.

Based on their findings, the study authors conclude that "virtual quality improvement learning networks in geographically-dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children."

The study authors also emphasized how the HEALTH COP intervention improved peer support among clinics. After sharing best practices regarding pediatric obesity with one another, physicians at each clinic could share such tips with colleagues and improve upon their own practice.

Photo: Dr. Ulfat Shaikh examines a patient. (UC Regents)

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