Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.
Improving access and systems of care for evidence-based childhood obesity treatment: Conference key findings and next steps.
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DOI：
10.1002/oby.21712
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发表时间：
2017-01
期刊：
影响因子：
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通讯作者：
Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment Conference Workgroup
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文献类型：
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作者：
Wilfley DE;Staiano AE;Altman M;Lindros J;Lima A;Hassink SG;Dietz WH;Cook S;Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment Conference Workgroup
改善护理系统，以推进美国预防服务工作组关于儿童肥胖治疗的建议的实施（即临床医生为肥胖儿童提供/推荐6-12个月内>25小时的强化、多成分行为干预，以改善体重状况），并扩大这些服务的支付范围。2015年7月，43名跨部门利益相关者参加了由医疗保健研究和质量机构，美国儿科学会健康儿童体重研究所和肥胖协会支持的会议。介绍科学证据、临床和支付实践的全体会议穿插着分组会议，以确定共识建议。儿童肥胖症治疗的共识建议包括：以家庭为基础的多元行为疗法;综合护理模式;和多学科护理团队。使用循证方案、训练有素的医疗团队、医疗监督和最低剂量或以上的治疗（例如>25小时）是确保有效提供高质量护理和实现临床有意义的体重减轻的关键组成部分。提出了在支付模式内确保循证肥胖症治疗报销的方法。持续的跨部门合作对于确保采取统一的方法来增加儿童肥胖症治疗的支付和获得以及扩大培训以确保护理质量至关重要。
To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care.