Reducing childhood obesity through coordinated care: Development of a park prescription program

Abstract

Major hindrances to controlling the current childhood obesity epidemic include access to prevention and/or treatment programs that are affordable, provide minimal barriers for participation, and are available to the general public. Moreover, successful childhood obesity prevention efforts will require coordinated partnerships in multiple sectors such as government, health care, school/afterschool, and the community but very few documented sustainable programs currently exist. Effective, community-based health and wellness programs with a focus on maintaining healthy weight via physical activity and healthy eating have the potential to be a powerful referral resource for pediatricians and other healthcare professionals who have young patients who are overweight/obese. The Miami Dade County Department of Parks, Recreation and Open Spaces in partnership with the University of Miami UHealth Systems have created a “Park Prescription Program (Parks Rx 4Health^TM)” that formally coordinates pediatricians, families, parents, caregivers, and child/adolescents to provide daily obesity-prevention activities. This Parks Rx 4Health^TM program that we describe here allows UHealth pediatricians to seamlessly refer their overweight and obese patients to Fit2Play^TM, an evidence-based, park-based afterschool health and wellness program. Measurable outcomes that include body mass index, blood pressure, fitness, and nutrition knowledge are being collected at baseline and at 3-and 6-mo after referral to document patient progress. Results are then shared with the referring physician so they can follow up with the patient if necessary. Identifying successful models that integrate primary care, public health, and community-based efforts is important to accelerating progress in preventing childhood obesity. Effective, community-based health and wellness programs with a focus on physical activity and nutrition education could be a powerful referral resource for pediatricians who have obese patients.

Keywords: Obesity; Overweight; Prevention; Community-based; Children; Adolescents; Primary care

Core tip: Childhood obesity continues to be a vexing clinical and public health challenge and is an epidemic that will not be solved in silos. Instead, coordinated, collective partnerships in multiple sectors such as government, health care, school/afterschool, the family, and the community give the most promise for sustainability of healthy weight in children and adolescents. The described Parks Rx 4Health^TM program will enhance care coordination among pediatricians, families and community-based providers to encourage and monitor overweight/obese youth. It will be increasingly important to capitalize on existing resources such as local park systems to conduct prevention efforts to lower current obesity and related comorbidity trends.