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

Objective: We 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. Methods: During 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. Results: Families 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. Conclusion: Goal setting with referral for more intensive lifestyle counseling for obesity prevention in high risk families is feasible and acceptable in primary care. Practice implications: Patient educators can be integrated into primary care to achieve preventive care goals.