Implementation of a pilot primary care lifestyle change intervention for families of pre-school children: Lessons learned

ObjectiveWe used Glasgow's RE-AIM framework to evaluate the feasibility of a primary care-based intervention to decrease behaviors that place urban children at risk for obesity.MethodsDuring preventive visits of 2–5-year olds between February 2006 and May 2007, parents completed a health behavior assessment. Primary care providers engaged parents in brief goal setting and referred them to a lifestyle counselor. Evaluation involved medical record review, interviews with staff and clinicians, and health behavior assessment via a pre- and post-intervention telephone survey.ResultsFamilies reached by the intervention did not differ from families who were not. The intervention was adopted by 14 of 17 clinicians. The health assessment was implemented in 32% of preventive visits (N = 354). Of those, goal setting by physicians occurred in 59%, with 55% referred to the lifestyle counselor. We were unable to demonstrate effectiveness to change adult or child nutrition or physical activity, as complete data were available for only 34 families.ConclusionGoal setting with referral for more intensive lifestyle counseling for obesity prevention in high risk families is feasible and acceptable in primary care.Practice implicationsPatient educators can be integrated into primary care to achieve preventive care goals.