Randomized controlled trial of a Wellness Action Plan to promote healthy diet and activity in pediatric primary care

Abstract

Introduction: Diet and activity counseling is recommended during all well child visits to promote optimal health and prevent childhood obesity. The objective of this study was to determine the effectiveness of a novel Wellness Action Plan aimed at: 1) improving parent recall of diet and activity plans made during routine well child visits 2) increasing adherence with plans, and 3) enhancing parents' identification of their child's weight category.

Methods: Parents of children 2.5 to 14 years (n = 181) seen at a pediatric primary care clinic in Milwaukee, Wisconsin between March and August of 2013 received standard diet and activity counseling from their physician (both control and intervention groups). In addition, parents randomized to the intervention group were asked to complete a Wellness Action Plan, where established diet and activity goals were documented. Parents completed surveys about BMI identification, plan creation, and plan adherence pre visit, post visit, and at 1 and 3 months.

Results: Intervention parents were significantly more likely to recall diet (p = 0.003) and activity (p = 0.03) plans at 3 months and were also more likely to report adherence with diet (p = 0.006) and activity (p = 0.08) plans at three months. There was no difference between groups in their ability to correctly identify children's weight categories (p > 0.05).

Conclusion: The Wellness Action Plan was associated with higher parent diet and activity plan recall and self-reported adherence. The Wellness Action Plan is a potentially important counseling tool that can be used to help parents make lifestyle modifications for their children.

Clinical trial registration: ClinicalTrials.gov, Identifier NCT02185248.

Keywords: Diet; Health promotion; Obesity; Pediatrics; Physical fitness; Preventive medicine; Primary health care; Primary prevention.

Fig. 1

Wellness Action Plan tool desgined for randomized controlled trial in a primary care clinic in Milwaukee, WI from March to August of 2013. The tool was created to help physicians with diet and activity health promotion counseling in pediatric primary care in order to promote optimal growth.

Fig. 2

CONSORT flow diagram (Harris et al., 2009) for Wellness Action Plan randomized controlled trial in a primary care clinic in Milwaukee, WI from March to August of 2013. ^aThe demographic profile (age, gender, race, insurance type, and baseline BMI) of children who were lost to follow-up was not significantly different than the profile of those who had continued participation.