Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

 - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
 - Percentage of patients with counseling for nutrition
 - Percentage of patients with counseling for physical activity

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Report a total score, and each of the following strata:
Stratum 1 - Patients age 3-11  
Stratum 2 - Patients age 12-17

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Over the last three decades, childhood obesity has more than doubled in children and tripled in adolescents. Approximately 15 percent of children and adolescents in the United States are overweight and 17 percent are obese (Fryar, Carroll, & Ogden, 2014). Childhood obesity has both immediate and long-term effects on health and well-being. 

Children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, stroke and several types of cancer (Centers for Disease Control and Prevention, 2013.

The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014). 

Since obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).

U.S. Preventive Services Task Force (2017) - The task force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)
 
American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - 

- Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. 
- Assess barriers to healthy eating and physical activity. 
- Provide anticipatory guidance for nutrition and physical activity.

Higher score indicates better quality

Centers for Disease Control and Prevention. (2013). Adolescent and school health: Childhood obesity facts. Retrieved from https://www.cdc.gov/obesity/data/childhood.html

Finkelstein, E. A., Graham, W. C. K., & Malhotra, R. (2014). Lifetime direct medical costs of childhood obesity. Pediatrics, 133(5), 854-862. Retrieved from http://pediatrics.aappublications.org/content/early/2014/04/02/peds.2014-0063.full.pdf+html

Fryar, C. D., Carroll, M. D., & Ogden, C. L. (2014). Prevalence of overweight and obesity among children and adolescents: United States, 1963-1965 through 2011-2012. Health E-Stats. Retrieved from https://www.cdc.gov/nchs/data/hestat/obesity_child_11_12/obesity_child_11_12.htm

Hagan, J. F., Shaw, J. S., & Duncan, P. M. (eds.). (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents, 4th ed. Elk Grove Village, IL: American Academy of Pediatrics.

U.S. Preventive Services Task Force. (2017). Screening and interventions for overweight in children and adolescents: Recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-children-and-adolescents-screening 

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The visit must be performed by a PCP or OB/GYN. 
Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.

TBD

Patients 3-17 years of age with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period

Equals Initial Population

Patients who have a diagnosis of pregnancy during the measurement period.

Exclude patients whose hospice care overlaps the measurement period.

Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period
Numerator 2: Patients who had counseling for nutrition during the measurement period
Numerator 3: Patients who had counseling for physical activity during the measurement period

Not Applicable

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For every patient evaluated by this measure also identify payer, race, ethnicity and sex

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