Publication Date



Objective: Pediatric obesity is a growing epidemic, yet effective preventative interventions remain elusive. The American Academy of Pediatrics recommends universal exercise and nutrition counseling as the initial step in prevention of pediatric obesity; however, there is no one established method for the ideal delivery of this counseling in the primary care setting. This practice improvement project aimed to improve the delivery and documentation of pediatric healthy behavior counseling by implementing the use of motivational interviewing (MI) and patient-driven goal setting during well-child visits. Methods: The clinic team in this federally qualified health center implemented use of an interactive behavior survey and goal-setting worksheet during all well-child checks to guide delivery of MI-based pediatric obesity counseling. Patient goals were documented in the EHR for future reference and reinforcement. Follow-up counseling was scheduled for patients with BMI in the overweight or obese range. Results: In the 2 weeks prior to implementation, healthy behavior counseling was documented in 0% of well-child chart notes; no charts included patient-specific goals. During the 12-week implementation, healthy behavior counseling was documented in 50% and patient-specific goals in 37% of well-child visits. Additionally, 31% of well-children were scheduled for follow-up counseling, including 100% of children with BMI in the overweight or obese range. The provider and team expressed satisfaction with the intervention, citing increased patient engagement. Conclusion: Motivational interviewing with the use of patient-specific goal setting during well-child visits is an effective method for improving the delivery of pediatric obesity prevention counseling in the primary care setting.


Overweight children; Obesity in children--Prevention; Motivational interviewing; Pediatrics--Research

Publication Information

NRS 597 - Practice Improvement Project

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Document Type

Doctoral Project