Study design and baseline description of the BMI2 trial: reducing paediatric obesity in primary care practices.

OBJECTIVES: This study will test the efficacy of motivational interviewing (MI) conducted by primary care providers and dieticians among children ages 2-8 years old with a body mass index (BMI) ≥ 85th and ≤ 97th percentile. METHODS: Forty-two practices from the American Academy of Pediatrics, Pediatric Research in Office Settings Network were assigned to one of three groups. Group 1 (usual care) measures BMI percentile at baseline, and at 1- and 2-year follow-ups and receives standard health education materials. Group 2 providers deliver three proactive MI counselling sessions with a parent of the index child in Year 1 and one additional 'booster' visit in Year 2. Group 3 adds six MI counselling sessions from a trained dietician. The primary outcome is the child's BMI percentile at 2-year follow-up. Secondary outcomes include parent report of the child's screen time, physical activity, intake of fruits and vegetables, and sugar-sweetened beverages. RESULTS: We enrolled 633 eligible children whose mean BMI percentile was 92.0 and mean age of 5.1. The cohort was 57% female. Almost 70% of parents reported a household income of ≥ $40,000 per year, and 39% had at least a college education. The cohort was 63% white, 23% Hispanic, 7% black and 7% Asian. Parent self-reported confidence that their child will achieve a healthy weight was on average an 8 (out of 10). CONCLUSION: To date, several aspects of the study can inform similar efforts including our ability to use volunteer clinicians to recruit participants and their willingness to dedicate their time, without pay, to receive training in MI.

Patient satisfaction in an observation unit: the Consumer Assessment of Health Providers and Systems Hospital Survey.

BACKGROUND: The growing demand for inpatient beds in Singapore has led Tan Tock Seng Hospital to set up an observation medicine unit where patients are monitored and discharged within a 24-h period. METHODS: Using the Consumer Assessment of Health Providers and Systems (CAHPS) Hospital Survey, this descriptive study examines the satisfaction levels of patients admitted into an observation unit, in particular the communication between patients and doctors and nurses. The anonymous surveys were either self-administered by the patients or by the research assistant or nurses. RESULTS: 271 patients completed the survey, with 96% of patients satisfied with the politeness (ie, treating them with courtesy and respect, listening carefully to them) of the medical staff. More highly educated patients were more satisfied with the communication between the doctors or nurses, compared with less educated patients (p<0.05). However, less educated patients gave a higher rating of their observation unit stay than more educated patients (p<0.05). CONCLUSION: With patient satisfaction becoming increasingly important as an indicator of the quality of care in the present healthcare environment, doctors and nurses should seek to improve their communication with their patients so as to ensure that patients are satisfied and receive quality care.