Peer-Led Focus Groups Identify Barriers to Healthy Lifestyle in African American Adolescents from Baltimore City.

Objectives: Black youth are disproportionately affected by the US obesity epidemic. Early-age obesity often continues into adulthood and is associated with a higher risk of diabetes, cardiovascular disease, and premature death. Few studies have incorporated community-based participatory research (CBPR) facilitated by youth to provide frank discussions among teens living in inner cities about challenges and facilitators in maintaining a healthy weight and to design teen-identified interventions. Design: Black youth (n=10) were recruited from a Baltimore City high school during the 2019 to 2020 academic year and were trained by seasoned investigators and mentored by graduate and undergraduate students on qualitative methods using CBPR. These youth then implemented focus groups with their peers aged 15 to 18 years (10 focus groups of 10 teens each). Topics included healthy lifestyle knowledge, behaviors, attitudes, and suggested interventions. Content analyses were conducted using dual-rater techniques. Results: Focus group themes yielded strengths and challenges of weight maintenance for Black youth at various levels, including in their personal lives, families, school, and community. Themes also suggested several technology-based possibilities using social media to reach Black youth about healthy living practices. Conclusions: Engagement of Black youth in CBPR projects can yield valuable data to design more culturally responsive and developmentally appropriate interventions. Youth are competent collectors of information to identify needed changes in their schools/communities and about the use of technology/social media to facilitate improved health practices among their peers and should be involved early in the process of developing targeted obesity prevention interventions and/or programs.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

BACKGROUND: Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. OBJECTIVE: To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. DESIGN: Prospective cohort. PARTICIPANTS: Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. INTERVENTION: s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. MAIN OUTCOME MEASURE: s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. RESULTS: Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. CONCLUSION: A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.