The Centers for Disease Control and Prevention recently reported that nearly 40 percent of adults and 20 percent of children in the United States struggle with obesity, and the prevalence rates continue to grow.
The cause of this phenomenon is multifaceted, but the long-term costs—both financial and functional—of treating the cascading health problems associated with obesity are astronomical, and the root of a public health crisis.
The time for action is now. A concerted effort between clinical and community partners is necessary to stop this runaway train before it derails the health of our nation.
St. Luke’s Children’s in Boise, Idaho, has been working to tackle this problem by providing clinical and community-based interventions to reduce the rates of childhood obesity among our patients.
YEAH! (Youth Engaged in Activities for Health) is a multidisciplinary program that includes a pediatrician, clinical psychologist, nurse, dietitian, and exercise specialist who collectively work with children and their families to develop healthier lifestyles.
The program is designed for youth between the ages of 6 and 16 who are referred by their physicians if their body mass index (BMI) is in the overweight or obese range. Following the referral, they must demonstrate a “positive readiness to change” before they are enrolled.
Families then attend a series of fun, interactive classes led by our team of experts. They gain hands-on skills to support healthy eating, experience new ways to be active in a community-based facility, and learn ways to reduce stress, avoid emotional eating, and maintain health behavior changes.
The importance of good nutrition and active lifestyle in achieving good health is reinforced with every encounter. Parents and caregivers are required to attend classes with their children to promote healthy habits within the family and help maintain changes after children exit the program.
Baseline and post-program data are gathered to assess initial health and measure program response. Assessments include BMI, waist circumference, resting heart rate, blood pressure, lipid panel, A1C, liver function, and thyroid function. We also use a quality-of-life indicator that has proven to be a valuable tool in understanding the nonclinical drivers of obesity in our pediatric population.
The goals of the YEAH! program are to stabilize BMI, improve healthy eating habits, reduce sedentary behavior and screen-time, increase physical activity, and improve quality of life in the context of physical, emotional, and social functioning.
Paying for the Program
YEAH! is a subsidized program of St. Luke’s Children’s because most insurers in our state do not yet reimburse for services provided in the treatment of childhood obesity. Without the health system’s support, this form of treatment would not be accessible or affordable for most of our families.
Idaho’s Medicaid program does cover clinic visits, and qualifying participants are granted financial assistance through their Preventive Health Assistance voucher to enroll in the program to make lifestyle changes that are necessary for good health.
More to Do
The complexity of childhood obesity treatment can’t be overstated. Through YEAH! we have seen significant, sustained change in some of our participants, while others struggle to implement and maintain the new skills they have learned.
High-quality clinical intervention appears be only one piece of the treatment puzzle, given that social determinants of health have a significant impact on outcomes. Poverty, food deserts, lack of green space, and unsafe neighborhoods make healthy lifestyle choices difficult for many of our children.
St. Luke’s Children’s is working to impact these areas as well, having embarked on an integrated population and community health strategy. We are investing resources and time to improve these issues and positively affect the health of our community.
As we continue to address the growing trend of childhood obesity in our country, we will be challenged to develop strategies beyond our clinic walls. We need to look critically at our Community Health Needs Assessment and hospital strategic plan to create opportunities to prevent childhood obesity and reduce the need for this form of intervention. Childhood obesity is a preventable problem.
Our clinical providers need to partner with our community leaders to develop a culture of health within our neighborhoods, schools, churches, and communities where the healthy choice is the easy choice and the opportunity to achieve optimal health is available to all.
Jean Mutchie, MBA, is service line program manager, St. Luke’s Children’s, Boise, Idaho; Amy Walters, MD, is director of behavioral health services, St. Luke’s Humphreys Diabetes Center, Boise, Idaho.
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