PubMed Health⌕ Search

Biomedical subjects

Frederick Trowbridge

Publications and source records attributed to Frederick Trowbridge.

5 recordsLinked to original sources
PubMed2005

Design and implementation of training to improve management of pediatric overweight.

INTRODUCTION: Clinicians report a low proficiency in treating overweight children and using behavioral management strategies. This paper documents the design and implementation of a training program to improve clinicians' skills in the assessment and behavioral management of pediatric overweight. METHODS: Two one-hour CME trainings were designed using published guidelines, research findings, and expert committee recommendations. The trainings were provided to clinicians of a managed care pediatric department, utilizing novel screening and counseling tools, and interactive exercises. Surveys and focus groups were conducted 3 and 6 months post intervention to examine clinician attitudes and practices regarding the screening and counseling tools. RESULTS: Post intervention, the majority of clinicians agreed that the clinical practice guidelines (Pediatric Obesity Practice Resource) and BMI-for-age percentile provided useful information for clinical practice. Clinicians reported an increased utilization of the recommended screening tools and changes in office practices to implement these tools. They offered suggestions to improve the ease of use of the tools and to overcome perceived clinician and/or patient barriers. DISCUSSION: A brief, cost effective, multi-faceted training and provision of counseling tools were perceived as helpful to clinical practice. Useful lessons were learned about tool design and ways to fit tools into practice. Training the entire health care team is advantageous to the adoption of new tools and practices.

Adolescent↗
PubMed2005

Evaluation of a training to improve management of pediatric overweight.

INTRODUCTION: Despite widespread concern about pediatric obesity, health care professionals report low proficiency for identifying and treating this condition. This paper reports on the evaluation of pediatric overweight assessment and management training for clinicians and staff in a managed care system. The training was evaluated for its impact on assessment practices and utilization of management tools. METHODS: A delayed-control design was utilized to measure the effects of two 60-minute interactive Continuing Medical education (CME) trainings for the pediatric health care teams. Chart abstraction was conducted at 0-, 3- and 6-months after training, recording the proportion of charts containing the recommended assessment methods and management tools. RESULTS: The training was associated with a significant increase in the utilization of some tools and practices, including charting BMI-for-age percentile (p < 0.001) and using a nutrition and activity self-history form (p < 0.001). Overall, from baseline to 3-months post training, charting BMI-for-age percentiles increased from zero to 25.2% and utilization of the self-history form increased from zero to 35.3%. These increases were sustained at 6-months post training. Other tools guiding clinician counseling were less widely utilized, although a behavioral prescription pad was used with 20% of overweight patients. DISCUSSION: A modest investment in clinician and staff training designed to be feasible in a clinical setting was associated with substantial increases in the use of appropriate tools and practices for the assessment and management of pediatric overweight. Such training may help to augment and improve the processes of pediatric health care delivery for addressing overweight. The training provides a viable model for future CME efforts in other health care settings.

Adolescent↗
PubMed2002

Summary and recommendations.

Iron deficiency affects the well being of > 1 billion people worldwide, with a range of adverse health and social consequences, yet efforts to address the problem have had only limited success. To better assess this issue and define more effective strategies, an international conference was convened in Atlanta, GA, in May 2001. Key policy issues discussed included setting a global goal for prevention and control of iron deficiency, building partnerships, and identifying ways to mobilize financial and human resources. The strengths and limitations of specific intervention strategies were discussed including iron fortification of staple foods and condiments, supplementation, dietary diversification, application of biotechnology to increase micronutrient content of staple foods, and public health measures such as infection control and provision of health care services. The importance of utilizing multiple and integrated strategies was emphasized. Representatives from several countries reported successful intervention programs as well as promising results in implementing new strategies. The critical role of effective communications was also emphasized, both to increase awareness of the impact of iron deficiency and to advocate for policy changes and resources to address the problem. The conference concluded with specific recommendations for action.

Anemia, Iron-Deficiency↗
PubMed2002

Prevention and control of iron deficiency: priorities and action steps.

The strengthening of global efforts to prevent and control iron deficiency requires priority setting and action steps in several key areas, including research, partnership formation, policy setting and the integration of intervention strategies. Research priorities include the development of improved assessment tools, evaluation of fortification strategies, improvement in interventions for infants, evaluation of combined intervention strategies to address multiple micronutrients and development and testing of interventions using genetically engineered foods with improved nutritional qualities. Policy priorities include the expansion of partnerships, balancing of advocacy, research and program implementation, and improved communications. Priorities in partnership formation include building strong linkages between public sector efforts and the food industry to enhance training, technical expertise and advocacy. Strategies to address iron deficiency should seek to integrate efforts in food fortification, supplementation, dietary improvement and complementary public health measures.

Anemia, Iron-Deficiency↗