CC BY-NC-ND 4.0 · Appl Clin Inform 2024; 15(02): 368-377
DOI: 10.1055/a-2283-9036
Research Article

Clinician Needs for Electronic Health Record Pediatric and Adolescent Weight Management Tools: A Mixed-Methods Study

Amy S. Braddock
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
K. Taylor Bosworth
2   School of Medicine, University of Missouri, Columbia, Missouri, United States
Parijat Ghosh
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
Rachel Proffitt
3   School of Health Professions, University of Missouri, Columbia, Missouri, United States
Lauren Flowers
2   School of Medicine, University of Missouri, Columbia, Missouri, United States
Emma Montgomery
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
Gwendolyn Wilson
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
Aneesh K. Tosh
4   Department of Child Health, University of Missouri, Columbia, Missouri, United States
Richelle J. Koopman
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
› Author Affiliations
Funding This work was made possible with support from Washington University in St. Louis CDTR (Grant Number P30DK092950 from the NIDDK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the CDTR or NIDDK (Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services National Institutes of Health). The research reported in this publication was supported by the University of Missouri-Columbia (Translational Research Informing Useful and Meaningful Precision Health) grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of TRIUMPH or the University of Missouri-Columbia.


Background Clinicians play an important role in addressing pediatric and adolescent obesity, but their effectiveness is restricted by time constraints, competing clinical demands, and the lack of effective electronic health record (EHR) tools. EHR tools are rarely developed with provider input.

Objectives We conducted a mixed method study of clinicians who provide weight management care to children and adolescents to determine current barriers for effective care and explore the role of EHR weight management tools to overcome these barriers.

Methods In this mixed-methods study, we conducted three 1-hour long virtual focus groups at one medium-sized academic health center in Missouri and analyzed the focus group scripts using thematic analysis. We sequentially conducted a descriptive statistical analysis of a survey emailed to pediatric and family medicine primary care clinicians (n = 52) at two private and two academic health centers in Missouri.

Results Surveyed clinicians reported that they effectively provided health behavior lifestyle counseling at well-child visits (mean of 60 on a scale of 1–100) and child obesity visits (63); however, most felt the current health care system (27) and EHR tools (41) do not adequately support pediatric weight management. Major themes from the clinician focus groups were that EHR weight management tools should display data in a way that (1) improves clinical efficiency, (2) supports patient-centered communication, (3) improves patient continuity between visits, and (4) reduces documentation burdens. An additional theme was (5) clinicians trust patient data entered in real time over patient recalled data.

Conclusion Study participants report that the health care system status quo and currently available EHR tools do not sufficiently support clinicians working to manage pediatric or adolescent obesity and provide health behavior counseling. Clinician input in the development and testing of EHR weight management tools provides opportunities to address barriers, inform content, and improve efficiencies of EHR use.

Protection of Human and Animal Subjects

This study complies with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was approved by the IRB (#2054598).

Publication History

Received: 09 October 2023

Accepted: 21 February 2024

Accepted Manuscript online:
08 March 2024

Article published online:
08 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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