Publication Date



Introduction: The purpose of this practice improvement project (PIP) was to implement a systematic obesity screening and referral process for children ages 3-17 at a county primary care clinic.

Method: This descriptive study used the Knowledge to Action Cycle to guide the implementation process. Mixed methods including quantitative data collection and a qualitative survey were used to analyze the process.

Results: Of 1,265 visits, BMI percentile was recorded for 874 (69%). Of these 874, 237 (27%) had a BMI≥95%. Forty (17%) children with BMI≥95% were screened for readiness to be referred to a BHC. And of those screened for readiness, only 9 (23%) were ready for a behavioral health intervention, 4 of whom attended an appointment. Barriers listed in the providers’ survey included: limited time and discomfort discussing obesity, and a negative association with a BHC.

Discussion: This PIP proved a challenge for the providers. However, valuable lessons were learned regarding barriers to avoid for similar implementation projects in the future.

Author Supplied Keywords

Children, Obesity, BMI, Screening, Referral, Implementation


Childhood obesity--Prevention; Health Screening

Publication Information

NRS 597: Practice Improvement Project

Copyright for this work is retained by the author.



Document Type

Doctoral Project

Included in

Nursing Commons