ANNUAL - center for children's healthy lifestyles & nutrition
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
center for children’s healthy lifestyles & nutrition
ANNUAL
REPORT 2020
A LETTER FROM THE DIRECTOR CONTENTS
Dear Friends, This past year also allowed us to develop stronger partnerships
with other research teams. As an example, we have been 4 FEATURED RESEARCHERS
As the director of the Center for Children’s Healthy Lifestyles working on several key activities with the Nutrition Obesity
& Nutrition (CHLN), it is my honor to present you with our
2020 annual report. This has been a year unlike any other
Research Center at the University of Colorado. A group of
researchers from our team traveled to their campus in 2019, and
18 2020 CHLN FUNDING PROVIDED TO MEMBERS AND STUDENTS
― from the outbreak of the COVID-19 pandemic and the
accompanying economic hardships to the acts of violence
in 2020 we invited some of their faculty to speak at our noon
seminars. It was clear there was a great deal of synergy between
19 ANNUAL UPDATE
23
against specific racial groups ― there is no doubt that our our teams, so in the fall of 2020 we released a call for joint pilot
team and our nation have been challenged. Despite this, we grants and selected one for funding. By funding this pilot grant GRANT INFORMATION
have continued to work together to bring attention, care and ― along with our CHLN funded pilot grant ― we are helping our
new discovery to all aspects of healthy lifestyles in children
and families.
junior investigators to gather the information they need to move
forward with bigger applications to the NIH.
24 TOP 10 GRANTS
Our year started out with great news. In January of
2020, our team was awarded the Research Team Award
Despite the challenges 2020 presented, we continue to be excited 25 TOP 18 PUBLICATIONS
and about our strategic goals and look forward to sharing our
from the Department of Pediatrics at Children’s Mercy, in
recognition of our significant contribution to research as a
progress with you in our next annual report. As always, if you
have any feedback or input, or want to join our team, please feel
26 ADMINISTRATION UPDATES
team. In February, we made an offer to the top candidate
for our open position of scientific medical director at
free to reach out at any time.
28 ACTIVE MEMBERS
73
CHLN ― Helena Laroche, M.D. We were seeking a National
Institutes of Health (NIH)-funded physician-scientist for CHLN AFFILITIATED POSTDOCTORAL FELLOWS
this role, and Dr. Laroche more than fits the bill. Thankfully,
Dr. Laroche agreed to join our team in the summer. 76 CENTER MEMBERS (ASSOCIATE)
76
However, much of our work came to a halt in March of 2020
with the outbreak of COVID-19. Our research was temporarily RESEARCH SUPPORT STAFF
put on pause, and our clinical work switched to primarily
telemedicine in order to protect patients, families and team
members. Events and national conferences were cancelled,
77 GRADUATE AND UNDERGRADUATE RESEARCH STAFF
and the locations where we reach a lot of our children were
closed. Because our team is composed of members from the 78 ADMINISTRATIVE STAFF
University of Kansas Medical Center and Children’s Mercy, as
well as other institutions, we were already used to having
many of our meetings and talks virtually, so these activities
were able to continue seamlessly during this difficult transition
period. Both of our key partner institutions released helpful
guidelines on how we could resume our research safely, and
projects were able to get up and running again.
Ann M. Davis, Ph.D., MPH, ABPP
CHLN Annual Report 2020 / 3
2
How Big Data Can Help Little Patients
Digital technology has transformed patient medical records from “Using EHRs and having access to a much larger sample size of Big data from EHRs reaches beyond a single institution. “What’s Many studies using big data are retrospective studies, which use
handwritten notes stored in filing cabinets to electronic health individuals has allowed us to examine youth and adults with IDD really powerful with the resources that we use is that they’re information already in EHRs. Prospective studies follow study
records (EHRs) stored on secure servers. Nearly 94% of hospitals in by diagnosis, by sex and by race to have a bigger picture of the populated by a large number of organizations so that you can subjects in real time, over time, and watch for outcomes, such as
the United States use an electronic data system to record and health complications of this population than in previous studies use that to compare your organization to your peers, and that’s the development or remission of a disease, during the study
maintain the health records of their patients. These records – that have used smaller sample sizes,” said Dr. Ptomey. (See the a powerful analysis,” said Dr. Hoffman. period. A recent study led by Dr. Davis looked at the feasibility for
millions of them– are called “big data,” and this data is being used article “Group Pools Expertise to Study Many Aspects of Down conducting prospective studies of children, including assessing the
for everything from medical research to reducing health care costs Syndrome Metabolism” on page 6 for more on this study.) Dr. Kyler has used data from Cerner and the Pediatric Health willingness of parents to have their children participate in research
to identifying disease trends for predicting epidemics. Information System database from the Children’s Hospital and how they felt about using the EHRs for research. “Using
Obtaining these health statistics for individuals with Down Association to amass data from more than 100,000 patients. She prospective studies, the Center for Children’s Healthy Lifestyles &
The data used for medical research is often de-identified, syndrome, autism and IDDs would not have been possible before is studying the dosage of drugs prescribed for hospitalized Nutrition can help to identify patients appropriate for various
meaning that all information that could connect the data to an the digitization of medical records and the big data revolution. children with obesity. Medications are prescribed by a patient’s studies, and bring these opportunities to the families and the
actual person, including name, address, Social Security number Using big data, researchers can study infants and children at weight—so many milligrams (mg) of a drug per kilogram—with children we serve,” said Dr. Davis. “This would help us to increase
and insurance information, has been stripped from the record. highest risk for certain conditions, measure outcomes and develop a maximum on the total number of mg that can be prescribed our reach and to get more families involved in our work.”
What remains is pertinent medical information, such as diagnoses, better treatment guidelines. for a child. For some children with obesity, the weight-dose
lab results and patient demographics. calculation exceeds the recommended maximum dosage. Big data is in its infancy, and researchers are just beginning to
Using large data sets, Dr. Kyler and colleagues can see the figure out how to use it and how to analyze the results.
Big Data, Better Practices dosages given to hospitalized children with obesity and whether Researchers at CHLN are committed to harnessing the power of
Whittling Down the Data to they follow the guidelines. big data to achieve the best benefits for the smallest of patients.
Practice guidelines are developed to help physicians manage the
Useful Information
numerous conditions they might encounter in their practice, in the
Big data in health care encompasses massive volumes of clinic or in the hospital. But they are guidelines, and not hard and
information that were never before available to researchers, fast rules. Mark Hoffman, Ph.D., Chief Research Information Officer
according to Earl Glynn, MS, Data Scientist at the Children’s Mercy for the Children’s Mercy Research Institute, is working with
Research Institute. "Researchers can use electronic health records, large-scale, de-identified EHRs to look at 1) when and how often
which are rich in diagnosis codes, to find the group they want to physicians follow guidelines and protocols, and 2) to see the
study,” he said. potential impact on patients’ outcomes.
"Researchers at the Center for Children’s Healthy Lifestyles & As an example, Dr. Hoffman cites a study conducted at Children’s
Nutrition are committed to using big data to study pediatric obesity Mercy to see how often opioids were prescribed for youth and
and other issues related to healthy lifestyles in children," said young adults who came to the emergency department with a
CHLN Director Ann Davis, Ph.D., MPH, ABPP. “Our initial work in this migraine. (Opioids are not recommended for migraine in this age
area shows that individuals are in favor of their medical records group.) Such a study can give the institution real-world information
being used in this way, to answer important questions.” on how well it is following guidelines.
Lauren Ptomey, Ph.D., Associate Professor in Internal Medicine at Kathryn Kyler, MD, Hospitalist at Children’s Mercy and a member
the University of Kansas Medical Center and a member of the of the Center for Children’s Healthy Lifestyles & Nutrition, has used
Center for Children’s Healthy Lifestyles & Nutrition, wanted to big data to study how obesity affects hospitalized children. “I’ve
examine the prevalence of obesity and other health conditions in used large data sets from Children’s Mercy, looking at every single
youth and adults with Down syndrome, autism spectrum disorder hospitalization that has happened since we had EHRs starting
and other intellectual and developmental disabilities (IDDs) who back in 2008,” she said.
had been seen by the University of Kansas clinics and hospital
from January 2008 to September 2019. Using big data, Dr. Ptomey Among her findings, Dr. Kyler discovered that children with obesity
and colleagues found 2,731 patients with these diagnoses. hospitalized at Children’s Mercy are more likely to be in infectious
diseases and neurology inpatient units than non-obese inpatients.
CHLN Annual Report 2020 / 5
4
Group Pools Expertise to Study Many
Aspects of Down Syndrome Metabolism
Parents of children with Down syndrome know they might need a at Children’s Mercy. By applying what’s known about genetic risks Effects of Physical Activity directly with clinicians and addressing questions that patients and
team of specialists to assure their children’s growth and potential. for obesity in the general population, the researchers will look to families have themselves. Using this interdisciplinary approach
Individuals with Down syndrome are at increased risk for obesity, see if these risks are overrepresented in the population with To counter weight gain among individuals with Down syndrome, makes our research very real in that we can provide answers in a
heart defects, obstructive sleep apnea, thyroid disease, anemia, Down syndrome. clinicians advocate physical activity. Several researchers in the direct way to families.”
hearing loss, hip defects, leukemia and Alzheimer’s disease. Down Syndrome Metabolism Group are examining how physical
Despite this, people with Down syndrome are an under- activity affects everything from overweight, obesity, cardiovascular
researched community. Additionally, given the broad disciplines Overweight and Obesity health and Alzheimer’s disease in the Down syndrome population. References
involved, research findings may not be shared among those
The prevalence of obesity in youth with Down syndrome is about Bethany Forseth, Ph.D., Postdoctoral Fellow in Pediatrics at the 1. Ptomey LT, Walpitage DL, Mohseni M, Dreyer Gillette ML,
caring for patients with Down syndrome.
twice that of the general population. University of Kansas Medical Center and the Center for Children’s Davis AM, Forseth B, Dean EE, Waitman LR. Weight status
In 2018, researchers in the Center for Children’s Healthy Lifestyles Healthy Lifestyles & Nutrition, is interested in finding valid and associated comorbidities in children and adults with
& Nutrition formed the Down Syndrome Metabolism Group, the In a first-of-its-kind pilot feasibility study, CHLN researchers are measures of physical activity for children with Down syndrome Down syndrome, autism spectrum disorder an
first of several special interest groups started at the center so examining the metabolic mechanisms that may contribute to the and the impact of physical activity on overweight and obesity. intellectual and developmental disabilities. J Intellect
researchers could learn from each other and collaborate on increased risk of obesity among individuals with Down syndrome.
Disabil Res. 2020 Sep;64(9):725-737.
They are measuring factors such as leptin, a “hunger hormone” “Kids with Down syndrome have to work harder to burn calories,”
research projects related to special topics. Until the formation of
that is typically higher in children with Down syndrome, as well as said Dr. Forseth. “They also have less muscle tone and that can 2. Ptomey LT, Szabo-Reed AN, Martin LE, Mayo MS,
the group, researchers ran independent projects.
resting metabolic rates and body composition, and will be impact how they walk or perform certain activities or how their Washburn RA, Gorczyca AM, Lepping RJ, Lee P, Forsha DE,
“We saw the potential for an excellent transdisciplinary team who answering some important questions. For instance: Is resting bodies are able to adapt to physical activity.” Sherman JR, Danon JC, Donnelly JE. The promotion of
were not working together,” said CHLN Director Ann Davis, Ph.D., energy expenditure — the amount of calories burned while not physical activity for the prevention of Alzheimer’s disease
Daniel Forsha, MD, MHS, FASE, a Cardiologist at the Children’s
MPH, ABPP. The group, comprised of researchers in cardiology, moving — actually lower in children with Down syndrome? Robin in adults with Down syndrome: Rationale and design for a
Mercy Heart Center and member of the Center for Children’s
psychology, genetics, physiology and endocrinology meets once Shook, Ph.D., Research Assistant Professor in Pediatrics at 12-month randomized trial. Contemp Clin Trials Commun.
Healthy Lifestyles & Nutrition, is looking at the cardiovascular
a month. Children’s Mercy, will find out using the sophisticated equipment 2020 Jun 30;19:100607.
effects of exercise and weight loss in adolescents with Down
at Children’s Mercy Energy Balance Research Lab in the Center for
“In early days they explored each other’s expertise,” said Dr. Davis, syndrome. About 50 percent of babies born with Down syndrome
Children’s Healthy Lifestyles & Nutrition.
“and this resulted in multiple collaborations.” have a heart defect. He intends to examine the effects of exercise
In recently published study,1 led by Lauren Ptomey, Ph.D., in adolescents with Down syndrome, comparing those with and
Professor in Internal Medicine at the University of Kansas Medical without congenital heart defects.
Beyond Chromosome 21 Center and member of the Center, the Center for Children’s
As individuals with Down syndrome age, their risk increases
Healthy Lifestyles & Nutrition team examined weight and related
Down syndrome, which is also known as trisomy 21, is a genetic rapidly for developing Alzheimer’s disease. In fact, almost all
comorbidities (congenital heart disease, sleep apnea, type 2
disorder that occurs when an individual has three copies of individuals with Down syndrome display pathology associated
diabetes, dementia, hypothyroidism and hypertension) in children
chromosome 21 instead of two. Understandably, most of the with Alzheimer’s disease beginning as early as age 30. Dr. Ptomey
and adults in three groups: Down syndrome, autism and
genetic research to date has focused on chromosome 21. is leading a study to explore, for the first time, the potential impact
intellectual and developmental disabilities (IDDs). Among the
Unfortunately, this single defect doesn’t explain all the symptoms of moderate-to-vigorous physical activity in the development of
study’s findings, both children and adults with Down syndrome
and comorbidities, such as obesity, that are overrepresented in Alzheimer’s disease in adults with Down syndrome.
had the highest rates of obesity/overweight compared to those in
the population of people with Down syndrome. the other groups, and children with Down syndrome are at the
Research that Translates to Practice
highest risk for developing obesity-related comorbidities.
“We thought it would be interesting to apply a more broad genetic
approach to Down syndrome to see if there are additional The intention of the Down Syndrome Metabolism Group is to bring
Children with Down syndrome usually stay on the same weight-
genetic risks that make these individuals more susceptible,” important research findings into clinical practice to help improve
gaining curve as children without Down syndrome, but when they
said Elin Grundberg, Ph.D., of the Genomic Medicine Center at the lives of individuals with Down syndrome and their families.
hit puberty they begin gaining weight at higher rates. Meredith
Children’s Mercy and a member of the Center for Children’s Dryer Gillette, Ph.D., Pediatric Psychologist at Children’s Mercy and
Healthy Lifestyles & Nutrition. “Oftentimes research is done in a lab under very controlled
member of the Center for Children’s Healthy Lifestyles & Nutrition,
conditions and it takes a long time for that information to make it
is conducting a study to map the trajectory of weight gain in
A pilot study is gathering DNA samples (from bloodwork or cheek back to a clinic and especially back to the patients themselves,”
children with Down syndrome with the hope of understanding the
swabs) from volunteer patients from the Down syndrome clinic explained Dr. Shook. “Whereas in this group, we are working
best age to start weight management intervention.
CHLN Annual Report 2020 / 7
6
How the CHLN Team Leveraged Technology
to Meet Family Needs During the Pandemic
When the COVID-19 pandemic made its way to the Midwest in Dr. Sweeney agreed and added, “Our team is incredibly flexible highlighted community partners and the good work they’re doing. But with COVID-19, many kids were at home, spending hours
March 2020, the Center for Healthy Lifestyles & Nutrition (CHLN) and creative. We found a way to effectively meet our patients’ The team shared content on the website, as well as on Instagram, sitting in front of screens. “They weren’t getting structured activity
team quickly pivoted its clinical, educational and research needs, despite the challenges of COVID.” Facebook and YouTube. And, they did all this in just a matter from PE or recess, or even walking to school,” Dr. Carlson said.
programs to take advantage of emerging technology, better of days!
meeting patient, family and community needs at this critical time. With patient visits up 15 to 20% over this time last year, and 60% With Stay Active, an instructor from CHLN delivered two short
of appointments now being conducted via telehealth, the team Data show that from March to May 2020, Fit-Tastic had more 10-minute physical activity lessons each week during the Fall 2020
will continue to assess effectiveness for their complex patient than 1,000 additional visitors to its website, representing a 343% semester to the 75 students who volunteered for the program.
population, but all signs point to continued use of telehealth, even increase in activity over the same time frame the previous year. But To encourage kids to exercise, the program supplied them with
Clinical Team Shifts to Telehealth
after the pandemic passes. most importantly, this has been a valuable resource for parents, smartwatch fitness trackers from Garmin, which logged daily step
The CHLN’s Weight Management program partners with families, as demonstrated by comments like this: “These support pages are counts and minutes of physical activity. Parents received an email
children and teens to help them achieve and maintain a healthier spot on and I cannot express enough the importance of mental newsletter each week with advice on encouraging their kids to be
weight. These clinical programs include the Promoting Health A Fit-Tastic! Response to COVID health for all!” active during the pandemic.
in Teens and Kids (PHIT Kids) Clinic, the Special Needs Weight
12345 Fit-Tastic! is the Center’s initiative focusing on behaviors Data collected from the fitness trackers was used to generate
Management Clinic, Metabolic-Bariatric Clinic and Surgical Weight
important for kids to engage in every day: STAY ACTIVE TARGETS 4TH AND automated texts sent to parents. Children’s Mercy also received
Loss Program and group programs.
1 hour or more of physical activity 5TH GRADE STUDENTS the data for research, plus teachers could request aggregated
In-person clinic visits were a barrier for families who lacked 2 hours maximum screen time class-level data.
reliable transportation and for parents who couldn’t take time 3 servings of low or non-fat milk or yogurt As students headed back to school this fall, the Center quickly
launched a program designed to keep them moving by delivering “This project was a collaborative effort across multiple center
away from work to travel for medical appointments. 4 servings of water, not sugary drinks
physical activity sessions to virtual classrooms. Called Stay Active, members that we hope kept kids moving,” Dr. Carlson said,
5 or more servings of fruits and vegetables
“We had been wanting to provide our patients with more the program was funded by a grant from the Claire Giannini Fund “and will provide valuable insights into how we can support them
opportunities for virtual visits, even before the pandemic,” said Fit-Tastic already had its own website (fittastic.org) and social and targeted fourth and fifth grade students in the Kansas City, going forward.”
Brooke Sweeney, M.D., FAAP, DABOM, Medical Director, CHLN. media following prior to the pandemic. But Robin Shook, Ph.D., Mo., and Hickman Mills schools, districts with limited resources
“Weight management is a high-frequency intervention. It’s most Assistant Professor and Director, Weighing In with the Center, and and stressed by COVID.
effective when you have a lot of contact in real time with families Shelly Summar, MSEd, RD, LD, Program Manager, Weighing In,
over time.” along with the CHLN team of Matt Kleinmann, Emily Meissen- “We know that usually school is a huge source of kids’ physical
Sebelius, Bryce Miller and Elizabeth Wilson, quickly recognized the activity,” said Jordan Carlson, Ph.D., Associate Professor of
The pandemic provided the opportunity to jumpstart a telehealth need for additional reliable resources to help families and kids Pediatrics at the Center. Dr. Carlson conducted a 2015 study that
program, offering patients and families a way to stay engaged stay active, while staying at home. found roughly half of kids’ daily physical activity comes from time
with these programs from the safety of their homes. spent at school.
Initially, the team had to quickly push past reductions in staff “With COVID, families were spending more time in front of screens,
and logistical challenges to scheduling and connectivity to make getting less physical activity, and not eating right,” Shelly said. “We
telehealth successful. wanted them to have access immediately to the resources they
needed to be healthy.”
Families had to adapt fast, too. Some had to purchase scales and
blood pressure cuffs to share vital signs virtually, while others had And that’s exactly what this team did. With help from a grant from
problems with connectivity. Ultimately, most have been able to the Enid and Crosby Kemper Foundation grant, they instantly
make telehealth work. created a new tab on their website, “Fit-Tastic! at Home!” They
also formed a 20-member parent advisory group, asking
“Telehealth has made it possible for us to offer families exactly them for topic suggestions and adding resources to respond to
what they need, whether that’s an in-person visit, a telehealth their concerns.
appointment, or a hybrid model,” said Meredith Dreyer Gillette,
Ph.D., Clinical Psychologist, CHLN. CHLN team members and their colleagues offered advice on
everything from family mental well-being to keeping doctor
appointments to how to safely return to school. They even
CHLN Annual Report 2020 / 9
8
Shedding Light on Long-term
Obesity Risks
Two-part, NIH-funded Adolescent Study features enhanced metabolic function and proper regulation of In the more immediate future, the team hopes to be able to more light on understanding energy balance in adolescents, and
Explores Relationship Between Metabolism, appetite, which prevents the development of obesity. examine specific ties between physical activity, appetite control, in turn, could offer public health interventions that specifically
Appetite and Physical Activity and energy metabolism in adolescents. Dr. Shook says the target the mechanisms associated with weight gain during youth
researchers’ most important finding thus far is physical activity is — a major step forward in combating obesity.
Childhood obesity continues to be one of the most serious Two Studies in Five Years closely related to energy balance, both through the calories we
public health problems of the 21st century, given the prevalence, burn while being active as well as through what we consume
global reach and widespread health, economic, and social To test this hypothesis, Dr. Shook and his team will explore the via appetite regulation, however, there is still much more that The Research Team
consequences. Research Assistant Professor Robin Shook, Ph.D., links between physical activity and appetite in two studies over remains unknown.
at the Center for Children’s Healthy Lifestyles & Nutrition and the the course of five years. The first study will use a cross-sectional Ann Davis, Ph.D., MPH, ABPP, Director of the Center for Children’s
Department of Pediatrics hopes to take a deeper look at the root design to assess metabolic function and appetite control in 40 Healthy Lifestyles, and Dr. John Thyfault, FACSM, FTOS, Scientific
male and female adolescents. The participants will be stratified Director of the Center for Children’s Healthy Lifestyles, also are
causes of this global issue. He was recently awarded a five-year, Understanding the Impact of
$725,000 K01 award from the National Institutes of Health (NIH)/ by bodyweight—normal/average compared to overweight/ on the project; both are faculty at the University of Kansas
Early Interventions
National Institute of Diabetes and Digestive and Kidney Diseases obese—and physical activity levels—sedentary versus active. For Medical Center.
to examine factors that lead to the development of childhood the second study, the team will look at the influence of physical After these studies the team expects to have a clearer picture of
obesity and how those factors affect people later in life. This will activity on the same outcomes by randomly assigning sedentary the independent effects of physical activity and body weight on
include two studies focusing on the interaction between energy overweight/obese adolescents to either a structured-exercise energy metabolism and appetite in adolescents. This will shed
balance, insulin sensitivity and appetite regulation in adolescent group or to a no-treatment control group for three months. In
boys and girls. both studies, the team will conduct a measurement session to
assess appetite control and relevant variables under laboratory
conditions. Additionally, hyperinsulinemic-euglycemic clamps
Finding Balance will be used to assess insulin activity, and the participants in the
exercise group will perform a supervised, structured exercise
Dr. Shook’s primary research is focused on energy balance, which program three days per week.
is the relationship between what we eat, the amount of physical
activity we achieve, and our body weight and composition. His
research suggests that physical activity is good for our bodies Analyzing Common Threads
for lots of reasons, including helping us achieve energy balance.
Dr. Shook believes the more we understand the role of physical The specific aims of the two studies are:
activity in energy balance, the more we can tailor behavioral 1. To examine the association between physical activity and
interventions to help us live at a healthy weight. appetite control in adolescents, with metabolic function
serving as a mediator.
While, at the most basic level, weight gain is due to a chronic 2. To test if increased physical activity through an exercise
energy surplus, there are a number of still largely unknown intervention influences metabolic function and appetite
influences that affect the energy balance system. He says there is control.
a critical need to examine factors that may influence the energy
balance system in order to develop effective interventions for Dr. Shook says the long-term goal is to quantify the dynamic
prevention and treatment. relationships between various physiological and psychological
components of the energy balance system. Because energy
Traditional knowledge suggests body weight status and related balance is incredibly complex, involving hundreds of variables
peripheral signals are a key regulator of energy intake. Based on across a variety of areas such as physiology, psychology and
the team’s findings in adults and rodents, in addition to supportive the environments in which we live, Dr. Shook says it is impossible
work by others, however, they hypothesize high levels of regular to do this work in isolation, so it’s essential and rewarding to get
moderate-to-vigorous physical activity (MVPA) may result in a researchers from different fields together and on the same page.
favorable metabolic phenotype. This phenotype, they believe,
CHLN Annual Report 2020 / 11
10
Data Mining the
Electronic Medical Record
Researchers extract significant findings among all people, but especially early in the lives of children — residential density, street connectivity, land use mix, transit, Simple Screening Questions with
about healthy eating and active living and adolescents. Patient data in electronic medical record has parks and bike trails — may affect childhood obesity. Because Complex Applications
behaviors in children from annual well proven it can help uncover these solutions. Children’s Mercy’s primary care population is sweeping
and all-encompassing throughout the Kansas City area, the Dr. Shook’s work was a first step into using electronic medical
child visits
researchers were able to map neighborhood-level obesity record to show how the questions developed by the HLI can
In 2011, Children’s Mercy collaborated with community and Access to Thousands of Participants rates and physical activity supportiveness across the six-county predict a child’s weight trajectory. He says it is rare to have all
public health partners as part of the Healthy Lifestyles Initiative metro area. these screening questions asked and data collected annually; it
(HLI) to create an approach to assessing and promoting healthy In 2012, the HLI team successfully implemented questions showcases the institution-wide dedication Children’s Mercy has to
weight in kids. One goal of the HLI, led by the Weighing In to assess the 1-2-3-4-5 Fit-Tastic! lifestyle behaviors in the advancing research around children’s weight management. His
program and Center for Healthy Lifestyles & Nutrition, was to Children’s Mercy electronic health record. Patient data related Electronic Medical Record Data Indicate initial work is being expanded to evaluate the utility of the screener
establish a common message for community groups, public to these recommendations, while informative on an individual Risks for Obesity for quantifying risk for other metabolic diseases and markers such
health and health care providers, which included screening patient level, can be invaluable when aggregately analyzed to as hypertension and hyperglycemia.
questions for primary care providers to use at checkups. The understand risks, behaviors and environmental factors related Applying the HLI data in Dr. Shook’s research helped show the
evidence-based message was branded as “1-2-3-4-5 Fit-Tastic!” to childhood obesity. rates of occurrence of obesity in the Kansas City region and Dr. Carlson says as policymakers and city planners consider
(fittastic.org) and promotes one hour of physical activity, less how many kids are meeting national guidelines for physical neighborhood environment policies and projects, information
Dr. Hampl explained the HLI’s 1-2-3-4-5 Fit-Tastic! assessment activity, sedentary behavior and healthy eating. It also showed
than two hours of screen time, three servings of low or nonfat from his team’s study can be used to geographically target
was embedded in the Children’s Mercy electronic medical following the assessment’s five guidelines does in fact indicate
milk or yogurt, four servings of water, and five or more servings efforts and help find ways to increase health equity and access to
record, meaning patients’ parents or guardians are providing a lower occurrence of obesity in children. Those who achieved
of fruit and vegetables. ample physical activity opportunities in neighborhoods. Overall,
data about children’s healthy lifestyle behaviors during the one or none of the lifestyle recommendations were 1.45 to 1.71 these data suggest even relatively minor improvements to a
General Pediatrician and Professor of Pediatrics Sarah Hampl, check-in process at every well child visit. Primary care providers times more likely to have obesity than those meeting all five neighborhood’s-built environment — the addition of one or two
M.D., has been with Children’s Mercy since 1992, and she can then see this information, offer recommendations, and recommendations, and not meeting the guidelines for physical physical activity supportive features — has the potential to impact
worked with the HLI leadership group to create the assessment, make intervention goals, known as a healthy lifestyle plan, for activity meant a child was 65% more likely to have obesity. large numbers of people and reduce population rates of
which has allowed Assistant Professor of Pediatrics and Director nutrition and physical activity to pursue healthier outcomes He says these findings also underscore how important it is childhood obesity.
of Weighing In, Robin Shook, Ph.D., and Associate Professor of into adulthood. All this data has been in the electronic medical for pediatric primary care providers to talk with patients and
Pediatrics and Director of Community-Engaged Health Research record since the screener was introduced, and after years families to address these issues early. At a higher level, using data collected from electronic medical
Jordan Carlson, Ph.D., to analyze years of electronic medical of collecting it, Dr. Shook and Dr. Carlson each applied it in record has proven to have systemic implications. Obesity is
record data at Children’s Mercy. Their work has highlighted studies designed to answer questions about how factors like Dr. Carlson’s research on neighborhoods found more children determined by so many complex and underlying factors. Dr.
findings that will inform and guide important decisions made physical activity, screen time, food and water consumption, had overweight or obesity in lower income areas as well as in Hampl says if we can make it easier for primary care providers to
by medical providers, policymakers, community members and neighborhood characteristics and socioeconomic status relate neighborhoods with fewer physical activity-supportive features. assess these behaviors and give them tools to counsel families,
families for decades to come. to and influence health outcomes for children. Children in the one-third least walkable Kansas City metro it makes a big difference to slow obesity development on a
neighborhoods were 10 to 15% more likely to have overweight population scale. Early prevention and treatment may avoid
Dr. Shook’s study included more than 24,000 patients from 2013 or obesity than children in the one-third most walkable otherwise expected medical needs and cost for patients later in
to 2016 and examined the association between healthy lifestyle neighborhoods. Children who had access to parks and bike
Supporting Healthy Weight life; it also could decrease health care costs across the country.
practices and obesity. paths also tended to have a healthier weight status. Numerous Even though these electronic medical record screening questions
In the U.S., 13.7% of children ages 2-5, 19.3% of children ages neighborhoods where there is a co-occurrence of low physical are simple and straightforward — they are only one sentence
Dr. Carlson led a study that investigated how neighborhood
6-11, and 20.9% of children ages 12-19 are experiencing obesity1 activity supportiveness and high proportions of children with each — the team at Children’s Mercy has demonstrated their
factors such as walkability, park access and income contribute
and 33.4% ages 2-19 are classified as having overweight or obesity were identified. far-reaching value when it comes to understanding and abating
to children’s obesity risk, which had not been done before at this
obesity.2 Many factors are important to address these systemic risks for childhood obesity.
level across the Kansas City metro. His study used electronic
health issues at a young age, including physical activity and Dr. Carlson’s team created a series of maps that indicate
medical record for nearly 15,000 children, in which 42.6% had
community environments. The Center for Healthy Lifestyles & these areas of need to assist local leaders and medical
overweight or obesity and layered in geographic information
Nutrition researchers and community leaders want to know providers alike.
to compare how availability of six key neighborhood-built
how they can better support and encourage healthy weight
environment features reflecting physical activity supportiveness
CHLN Annual Report 2020 / 13
12
Developing the First-Ever Kansas City
Physical Activity Plan and Report Card
The facts are undisputed. According to the Centers for Disease “We had our first plan meeting in October 2019,” Dr. Shook said.
References and Relevant Publications Control and Prevention (CDC), for children and adolescents 2-19 But that was just the first of many. Over the past 13 months, this
years old, the prevalence of obesity is 18.5%, affecting 13.7 million team has conducted more than 55 meetings with more than 550
1. Ogden CL, Fryar CD, Martin CB, Freedman DS, Carroll MD,
children and adolescents in the United States. attendees representing a wide range of community organizations.
Gu Q, Hales CM. Trends in obesity prevalence by race and
The experts also agree the key to achieving and maintaining a Due to the pandemic, most of these meetings have been
Hispanic origin — 1999-2000 to 2017-2018. JAMA
healthy weight isn’t short-term; it’s about balancing a healthy diet conducted virtually, but this important work has continued.
published online August 28, 2020.
with regular physical activity for a lifetime. But how do we do that?
2. Fryar CD, Carroll MD, Ogden CL. Prevalence of overweight, That’s where the Center for Children’s Healthy Lifestyles & Nutrition
obesity, and severe obesity among children and (CHLN) comes in. Are We Making the Grade?
adolescents aged 2–19 years: United States, 1963–1965
“We know there are high rates of childhood and adult obesity in our One key aspect of creating an effective plan to address important
through 2015–2016. 2018.
region and low rates of physical activity,” said Robin Shook, Ph.D., local issues is measuring the impact of those initiatives. To provide
3. Shook RP, et al. Adherence with multiple national healthy Assistant Professor and Director of Weighing In with the Center for the Kansas City area with a baseline measure of physical activity
lifestyle recommendations in a large pediatric center Children’s Healthy Lifestyles & Nutrition. “This is not a new problem. and barriers related to implementation, this team also created
electronic health record and reduced risk of obesity. Mayo People have been trying to address these concerns for decades.” the first-ever 2020 Kansas City Regional Report Card on Physical
Clinic Proceedings. Volume 93, Issue 9, 1247-1255. Activity for Children and Youth (KCPA Report Card).
Though other plans have had limited success tackling these
4. Center for Children’s Healthy Lifestyles and Nutrition. (2020). This document characterizes current physical activity in the Kansas
issues, Dr. Shook and his team are taking a different approach,
Childhood Obesity and the Neighborhood Built City metropolitan region. Its format and content are based on the
developing and implementing the first-ever Kansas City Physical
Environment in the Kansas City Metropolitan Area. National Physical Activity Plan Alliance’s 2018 United States Report
Activity Plan (KCPA Plan). The plan takes a multi-sector approach
Card on Physical Activity for Children and Youth (National Physical
to the critical health issues of chronic disease prevention, obesity
Activity Plan Alliance [NPAPA], 2018).
and lack of physical activity.
Data for the KCPA Report Card were obtained through publicly
“We have created a plan that touches every aspect of the
available surveillance sources and CHNA data. Grades were
individual’s life—where they live, work, learn, play and pray.”
assigned in nine indicators of physical activity based on available
data, input from subject matter experts and discussion with the
core work group members of the KCPA Plan.
Sowing the Seeds of the KCPA Plan
The final grades in the indicators are as follows:
A summit in 2018 focused on the many factors that influence
Overall Physical Activity: C-
childhood obesity. Speaking at that summit was a board member
Sedentary Behaviors: C
of the National Physical Activity Plan, Bill Kohl, Ph.D., a Scientific
Active Transportation: F
Advisory Board Member of the CHLN, and a mentor of Dr. Shook’s.
Organized Sport Participation: B-
“I saw the progress that had been made at the national level since Active Play: Incomplete
the plan was introduced a decade ago, and I thought, we could Physical Fitness: Incomplete
do that in Kansas City, too,” Dr. Shook said. Family and Peers: Incomplete
School: Incomplete
With the well-established CHLN program Weighing In as a
Community and Built Environment: C
foundation for the initiative, this team started investigating what a
KCPA Plan might look like, and began securing funding for “Overall, the report card showed there is a lot of work we need to
the project. do,” Dr. Shook said. “But we are treating the report card as a way
to identify what we’re doing well, where we need to improve, and
where we need to focus our efforts going forward.”
CHLN Annual Report 2020 / 15
14
The goal is to update the report card every five years. The Core Sector Work Group is coordinated by Weighing In, which Resources
“The report card will help us gauge our progress when is supported in their coordination of the KCPA Plan by the Enid
implementing the physical activity plan,” Dr. Shook added. and Crosby Kemper Foundation and the Health Resources and Kansas City Physical Activity Plan:
“The changes we are talking about take time, but I suspect when Services Administration. https://www.kcphysicalactivityplan.org/
we do this again in 2025, we will see we are beginning to
Kansas City Physical Activity Plan Report Card:
make progress.”
https://www.kcphysicalactivityplan.org/kcpa-report-card
It Takes a Village
National Physical Activity Plan:
In addition to the community partners named here, we’d also like
Implementing the KCPA Plan https://www.kcphysicalactivityplan.org/nationalpaplan
to thank Margo Quiriconi, Director Community Health Initiatives
In the meantime, the KCPA Plan Playbook (KCPA Playbook) has for her support of our efforts, including sharing resources
been released. It is a brief overview of the strategies and priorities during COVID, sharing data from the Community Health Needs
the Kansas City region should consider adopting to foster a culture Assessment for the Report Card, and promotion of our efforts.
of active living. And work has begun to implement some of the Her support has been invaluable. Also, Sheila Montgomery,
sector priorities across the community. Director, Philanthropic Foundation Giving, for her help in identifying
funding, bringing it to us and supporting us through
It aims to foster a local culture that supports physically active
the application process.
lifestyles across the six county region, with the goal of improving
health, preventing disease and disability and enhancing the And, finally, we’d like to acknowledge the valuable contributions of
quality of life for all Kansas City area residents. our own team members, including:
Robin Shook, Ph.D.
“The KCPA Plan is helping align work related to physical activity
Assistant Professor and Director, Weighing In
across our region, so we are all moving in the same direction
to affect change,” said Shelly Summar, MSEd, RD, LD, Program Shelly Summar, MSEd, RD, LD
Manager, Weighing In. Program Manager, Weighing In
Dr. Shook agreed and added, “This is a long-term project. We view Emily Meissen-Sebelius, MSW
this as the road map for our journey to improving the health of our Project Coordinator, Weighing In
community, and how we will get there.”
Matt Kleinmann, MA
Research Assistant, Weighing In
Community Involvement Elizabeth Wilson, MA
Graduate Research Assistant, Weighing In
The Kansas City Physical Activity Plan is led by a Core Work Group,
which includes representatives from many key organizations Bryce Miller
in Kansas City representing various societal sectors. CHLN was Research Assistant, Weighing In
delighted that many key organizations were active participants in
this work, including: BikeWalkKC; the Calvary Community Outreach
Network; Children’s Mercy Kansas City, Weighing In and Primary
Care; the City of Kansas City Public Works; the Health Resources
and Services Administration; KC Healthy Kids; KCMO Parks and
Recreation; the UMKC Health Equity Institute; and the Office of the
Assistant Secretary for Health.
CHLN Annual Report 2020 / 17
16
2020 CHLN Funding Annual Update from Five Key
Provided to Members and Students Programmatic Areas at CHLN
CHLN Awarded Grants Congratulations to these members who won the funds for 2020: • CHLN clinical faculty and staff gave local, statewide and
Our grant programs are strategically focused on providing support Development and Pilot Testing of My Plan, a Personalized national talks during 2020. Audiences included family
to our more junior colleagues, in order to eventually grow the mHealth Intervention for Adolescent Obesity Education medicine and pediatric residents, physician assistant
number of NIH R01 funded investigators at CHLN. This will enable Drs. Lauren D. Gulley (CU NORC) and Dr. Christopher C. Cushing and medical students and practicing registered dietitians
us to reach our center’s goals of applying for larger group grants, (CHLN); Direct Costs: $49,600 and pediatric primary care providers.
such as the NIH T32 training grant or the NIH Nutrition Obesity Award dates: January 1, 2021–12/31/2021 (with option for 2nd year) • Dr. Christie Befort was senior author of a publication
Research Center (NORC) grant, for example. We have transitioned Clinical Research highlighting patient perspectives on obesity. Dr. Cristina
our funds for CHLN-funded graduate students into a CHLN-funded Fernandez expanded the training options in pediatric
postdoctoral position with the goal of moving toward applying for Center Funded Postdoctoral Fellows obesity for residents and she and Dr. Brooke Sweeney
an NIH T32 training grant. We continue to support mechanisms are updating an obesity QI project for the American
including pilot funds, student travel grants, an equipment loan Our center engages in the training of a number of postdoctoral Board of Pediatrics. Dr. Fernandez also gave a weight
program and support from our clinical trials coordinators and fellows. Dr. Carolyn Bates was a second-year fellow in the joint management lecture at the Universidad del Valle
other research support staff. Finally, in partnership with the KUMC/CMH two-year psychology postdoctoral fellowship, and Dr. in Colombia.
Dana Bakula was hired as a new first-year fellow in this program Community Advocacy
Colorado Nutrition Obesity Research Center, we added a new pilot • Dr. Sarah Hampl continued in her multi-year role as
grant program in 2020, the details of which are below. in 2020. Both of these psychologists in training are pursing clinical chair of the American Academy of Pediatrics’ obesity
licensure hours and extensive research training as part of their clinical practice guideline writing committee and gave
experiences with CHLN. Dr. Bethany Hanson was also hired as a multiple presentations about childhood obesity and the
CHLN Pilot Grant CHLN research fellow and started in early 2020; she is primarily upcoming Missouri Medicaid obesity treatment benefit.
doing work with Dr. Ann Davis on the iAmHealthy grant. In 2020 Advocacy
Congratulations to these CHLN members who received $33,000 for we also hired Dr. Paul Hibbing as a postdoctoral fellow at CHLN, Strategic goal #3:
STRATEGIC GOAL #1:
the 2020 pilot grant program: primarily to work with Dr. Jordan Carlson on his funded research Increasing awareness of public/community agencies regarding
Increasing access to weight management services.
Serum biomarkers, diet, and liver metabolism in pediatric projects. So, our strategic focus as a center team on training weight management.
non-alcoholic fatty liver disease postdoctoral fellows may be new, but we are quickly developing a • The challenges of the pandemic led to the rapid
critical mass of fellows who are allowing us to develop a • At the institutional level, Drs. Beck and Hampl continued
Voytek Slowik (PI) with Michele Pritchard and Udayan Apte deployment of telehealth services in the Weight
more robust training program, which remains one of our key work in the Severe Pediatric Obesity Task Force and
CHLN 2020 Pilot Grant: $33,000 Management Clinics and group programs.
strategic goals. analyzed results of a follow-up survey on weight bias.
• Both new and established patients continued to be seen
Pilot grants for 2021 are due March 26th. Center employee wellness committee members are
and access to treatment was preserved. In fact, each
assisting in preservation of previous healthy food
of the Weight Management clinics had increased patient
environment gains following transition to a new food
Center funded Graduate Student volume compared to 2019. In addition, the clinical
CHLN/Colorado NORC Pilot Grant service vendor.
Travel Grants faculty consulted with a regional and an out of state
• Dr. Amy Beck served on several hospital diversity
health system, both of which desired to start or further
The Center partnered with the leadership of the Colorado The Center also offers graduate student travel grants, which allow and inclusion workgroups.
develop pediatric weight management services.
our CHLN graduate students to travel to national conferences to • Dr. Jordan Carlson was a member of the University
Nutrition Obesity Research Center (CU NORC) to offer our first joint • Drs. Jordan Carlson, Meredith Dreyer Gillette and Sarah
present data they have collected in partnership with their CHLN of Missouri-Kansas City Health Equity Institute.
pilot grant in 2020. The investigator team had to include a lead Hampl continued work on the CDC-funded Childhood
faculty mentors. Although many conferences were changed to • At the state level, Ms. Shelly Summar and Emily Meissen-
investigator from CHLN and a lead investigator from CU NORC. Obesity Research Demonstration (CORD) grant, in which
the virtual format, we still had many students who were active in Sebelius, Drs. Dreyer Gillette and Hampl continued
We are engaging in this joint program in order to inspire more family-based behavioral treatment will be piloted in
presenting research they had done at CHLN. Specifically, in participation in the Missouri Council for Activity and Nutrition.
collaboration between our two strong centers, and to support primary care clinics at Children’s Mercy and Freeman
2020 we funded Adrian Ortega, Jennifer Christofferson and • Ms. Meissen-Sebelius was co-chair of the early childcare
our junior investigators in working together to achieve the pilot Health Systems in Joplin, thus increasing access to obesity
Arwen Marker to attend the Society of Pediatric Psychology workgroup and Dr. Hampl was the chair of the
data necessary for future federal grant applications. We received treatment directly within these patient-centered
Annual Conference. healthcare workgroup.
several wonderful proposals, all focused on research related to medical homes.
• Drs. Dreyer Gillette and Hampl also participated in
healthy lifestyles in children and families.
STRATEGIC GOAL #2: MOCAN’s Healthy Weight Advisory Committee.
Increasing the effectiveness of healthcare professionals’
delivery of weight management services.
CHLN Annual Report 2020 / 19
18• Nationally, Dr. Amy Beck was a member of the American research projects are ongoing to look at outcomes specifically in We also began a new joint initiative with the Information Systems career faculty member. To support our training efforts, we also
Psychological Assn’s Division 54 Diversity Committee and children with Autism Spectrum Disorder and factors associated Development & Data Analytics team to streamline the data launched the operation of our new computer-based system for
wrote an op-ed for KevinMD.com. with success in the younger children with intellectual and collection on patients in clinic for research, quality improvement tracking trainees and their productivity from application through
• Dr. Jordan Carlson presented on environmental supports for developmental disabilities. Several patients from this clinic are and clinical care. The goal is to create a single dataset which is graduation. This system will provide us with an easy way to
youth active travel to school at a National Collaborative on either being followed for their post-op outcomes or preparing for updated frequently from which subsets of data can be pulled for summarize key training program metrics required for NIH
Childhood Obesity Research workshop. bariatric surgery, with high levels of success. One patient and her different projects. Additionally, we are working to streamline data proposals. We are grateful to both mentors and trainees for taking
• Dr. Danielle Christifano served as elected Treasurer and mother who are preparing for surgery with the help of our team from various sources to populate real-time dashboards to guide the time provide the data we need so we have all the training data
Membership Chair for the U.S. Developmental Origins of remarked, “The support of this team has been life changing for us.” individual patient care and organize and plan clinic flow. These we need at our fingertips when the need arises.
Health and Disease Society. may be within or outside of the electronic medical record
• Dr. Cristina Fernandez served as a member of the ACGME The metabolic bariatric clinic had nine patients undergo gastric depending on what is possible. For example, a dashboard to help The culmination of our strategic planning efforts also resulted in
Diversity Committee. sleeve in 2020, fewer than the previous two years due to the track where a patient is in completing the logistical and behavioral defining of key metrics to help us reach our goal of becoming the
• Dr. Helena Laroche continued on the advisory board for the number of surgeries placed on hold during COVID-19. We had 781 requirements for bariatric surgery. “go to” place for state-of-the-art education related to pediatric
Family Health SIG at the Society of Behavioral Medicine and clinical visits, an increase of 85 visits over the last year, which lifestyles. Key metrics include increasing competitive applications
gave presentations to local community coalitions. includes 94 post-surgical visits for 28 unique post-operative for our postdoctoral program and ensuring our trainees are
• Matt Kleinmann co-presented with local community patients. We now have 26 patients with 6-month post-surgery Education meeting their goals. We also aim to increase our education
partners. Dr. Valentina Shakhnovich advocated for inclusion data, showing an average of 19.5% weight loss and a range of presentations and increase education publications. With the
In spite of the pandemic, we were able to continue quite progress made this past year we are optimistic that we are on
of children with obesity in clinical trials. 12.5% to 28% at the 6-month time point. In 2020 we tested the
successfully with our education efforts in 2020. We continued to track toward achieving these goals.
Baritastic App for presurgical preparation in children and then
Other advocacy activities: Dr. Delwyn Catley served as offer our twice monthly noon seminar series which has always
offered it to all weight management patients during the time of
co-investigator on one local and two national grants to perform been offered remotely to facilitate the ability of our members to
COVID to improve communication and between-visit support.
policy analysis and impact of the Tobacco 21 initiative, as attend, wherever they may be at lunch time. The seminar features
Community
well as youth tobacco use associated with retailer violations. CHLN members and invited faculty from the region and around the
The PHIT Kids Clinic saw 1,080 patients in 2,587 visits in 2020.
He co-authored two related publications and two other country. As part of our increasing collaborations with the University Despite the many challenges of the previous year, 2020 was a
Despite the pandemic we were able to stay on track with
publications related to prescribing practices for opioid use of Colorado Nutrition Obesity Research Center, we now regularly resounding success for our community outreach efforts. Our
implementing the NIH study “Stay in Treatment” with recruitment
in youth. feature our University of Colorado colleagues as part of this series. mission is to align community programs to promote healthy
goals ahead of target, leading the two other sites in enrollment.
This year we also devoted occasional seminars to the “work in lifestyles through collaborative community-based approaches.
We have continued enrollment for the POWER registry despite the
progress” of center members so that center members can stay This spirit is perfectly envisioned in the new initiative we launched
pandemic. In all our clinics, we shared with families the virtual
Clinical resources for healthy nutrition, physical activity and other health
current with the ongoing activities of their colleagues including our in 2020 through generous funding from the Enid and Crosby
new post-doctoral fellows. The annual Kemper Healthy Lifestyles Kemper Foundation, the Kansas City Physical Activity Plan. The
habits during the pandemic compiled by the 12345 Fit-tastic
As for everyone on research and clinical medicine, 2020 was Lecture series presenter was Dr. Denise Wilfley from Washington goal of the Kansas City Physical Activity Plan is to identify and align
Healthy Lifestyles team.
a year to remember. We were moving along with our typical University (who is also a current member of our Center Scientific with community-specific, evidence-based strategies for improving
clinical processes and changed in three weeks to an almost Advisory Board). Dr. Wilfley gave a presentation entitled “Childhood physical activity across the Kansas City region. As part of the plan,
As part of our center’s strategic planning process, the clinical
100% telehealth provision of service. As we developed new Obesity: Translating Evidence Based Practice into Treatment.” We we hosted 55 meetings which attracted more than 500 individuals.
teams have three strategic goals:
processes for scheduling, providing telehealth appointments to also sponsored an academic scholarship conference featuring One event was the virtual Kansas City Physical Activity Summit on
home and safe procedures to see patients in the clinic, we began • Improve patient outcome Terence Ryan from the University of Florida, who presented on September 11, 2020. This half-day event included multiple breakout
intermixing both in person and telehealth visits per clinical needs • Improve patient engagement, retention, and satisfaction mitochondrial function. Last but not least, Kelly Cornett of the CDC rooms for the 115 attendees, a keynote address by Kelli Cornett of
and patient preference. In June we converted our in-person • Improve staff satisfaction was the keynote speaker at our Kansas City Physical Activity the Centers for Disease Control and Prevention’s Division of
group class to a new online group using the I Am Healthy Summit, giving a presentation on “Active People, Healthy Nation.” Nutrition, Physical Activity, and Obesity, and remarks by regional
curriculum developed by Dr. Ann Davis and her team. We had a We are formalizing methods to pull baseline metrics and setting elected officials.
total of 892 group visits serving 115 patients. 254 were group TH goals to improve these metrics over time. As an example, we will In 2019 we began our efforts to create a post-doctoral training
visits and 91 were individual coaching calls. We had a total of be tracking show rates at new and follow-up visits, patient program, and in 2020 we were pleased to see our efforts The Kansas City Physical Activity Plan Playbook was finalized
4096 individual clinic visits in 2020, a 22% increase over 2019. In satisfaction scores and length of visits. In addition, we will progress. In 2020 we saw the number of applicants rise and were and released in December 2020 and includes strategies and
addition, we completely transformed the amount of care delivered continue to expand and improve our between-visit and in-home pleased to welcome Dr. Paul Hibbing from the University of priorities to create a culture of active living across six societal
by telehealth, with 5% telehealth in 2019 and averaging 60% in offerings including coaching calls between group and clinic visits, Tennessee, Knoxville, Dr. Dana Bakula from Oklahoma State, and sectors (early childhood settings, schools, faith-based settings,
2020. pre and post-surgery coaching calls, and developing telehealth Dr. Rebecca Foright from the University of Colorado-Anschutz community recreation and parks, infrastructure, and health care).
groups. Medical Campus. To provide both well-rounded training and The playbook is designed to be an easy-to-read summary of the
Our special needs weight management clinic had 728 visits last mentorship opportunities for our faculty, our post-docs are Kansas City Physical Activity Plan A fully detailed report will be
year, a gain of 100 visits for the second year in a row. New mentored by an established career faculty member and an early released in March 2021. In 2021 this work will expand, with three
CHLN Annual Report 2020 / 21
20You can also read
