BACKGROUND: The Early Lifestyle Intervention (ELI) Clinic is an OU Physicians Pediatrics specialty clinic dedicated to helping children achieve healthier weights via behavioral modification through a multidisciplinary team approach. Children between 2–18 years of age from North Eastern Oklahoma are eligible for ELI referral if their BMI is at the 95th percentile or above. It is estimated that 30–40% of patients never make their ELI appointments after referral. This study explored predictive factors of patient follow-up to these appointments.

METHODS: A retrospective chart review of 121 pediatric patients with ELI referrals made between January 2010 and March 2018 was conducted. Patients were grouped into three categories based on follow-up status for this intervention: immediate (attended first ELI appointment made at time of referral), late (did not attend first ELI appointment but eventually saw ELI provider), and never attended an ELI appointment. Demographic, medical, and social data were extracted from each patient’s medical record, including comorbid conditions such as musculoskeletal pain and past medical interventions such as obesity counseling. Reported comorbidities and conditions in family medical histories were documented for each patient according to the organ system affected. Associations between clinical and family factors and follow-up status were evaluated using the χ2 test, Fisher exact test, 1-way analysis of variance, and Kruskal-Wallis H test in SPSS.

RESULTS: The majority of patients were Hispanic (n=73, 60.3%) and male (n=65, 53.7%), with an average age of 7.81 years (+ SD, 3.82 yrs). Frequency of obesity counseling from a healthcare provider and reported musculoskeletal pain differed significantly among groups. 31% of patients with timely follow-up experienced musculoskeletal pain compared to 3% of those with no follow-up and late follow-up. In addition, patients in the timely follow-up group had the highest frequencies of obesity counseling. The organ systems-based approach of conditions in family histories showed cardiovascular disease and endocrine disorders to be present in all patient groups with no significant difference across groups.

CONCLUSION: The results suggest that providers who document counseling their patients about childhood obesity more frequently prior to ELI referral can improve their patients’ follow-up rates. Additionally, musculoskeletal pain was the only comorbidity significantly associated with attending ELI clinic. This suggests that most comorbid conditions associated with childhood obesity have a limited effect on motivating parent/patient behavior to seek longitudinal intervention.