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Appl Clin Inform 2020; 11(02): 210-217
DOI: 10.1055/s-0040-1705106
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Adoption of an Electronic Medical Record Tool for Childhood Obesity by Primary Care Providers

Amy Williams
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
,
Christy Turer
2   Department of Internal Medicine-Pediatrics, University of Texas Southwestern, Dallas, Texas, United States
,
Jamie Smith
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
,
Isabelle Nievera
3   University of Missouri School of Medicine, Columbia, Missouri, United States
,
Laura McCulloch
4   Columbia/Boone County Public Health and Human Services, Columbia, Missouri, United States
,
Nuha Wareg
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
,
Megan Clary
5   Department of Child Health, University of Missouri, Columbia, Missouri, United States
,
Anuradha Rajagopalan
5   Department of Child Health, University of Missouri, Columbia, Missouri, United States
,
Ross C. Brownson
6   Department of Surgery and Alvin J. Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri, United States
7   Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
,
Richelle J. Koopman
1   Department of Family and Community Medicine, University of Missouri, Columbia, Missouri, United States
,
Sarah Hampl
8   General Pediatrics and Weight Management, Children's Mercy Hospital Center for Children's Healthy Lifestyles and Nutrition, Kansas City, Missouri, United States
9   Department of Pediatrics, University of MO-Kansas City School of Medicine, Kansas City, Missouri, United States
› Author Affiliations Funding This work was supported by the American Academy of Family Physicians Foundation Joint Grant Award Program, grant number: G1603JG. The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the American Academy of Family Physicians. Additional support was provided by National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of under award numbers 2P30DK092949 and P30DK092950. The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the National Institutes of Health.
Further Information

Publication History

03 December 2019

23 January 2020

Publication Date:
18 March 2020 (online)

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Abstract

Background Primary care providers are tasked with the increasingly difficult job of addressing childhood obesity during clinic visits. Electronic medical record (EMR)-enabled decision-support tools may aid providers in this task; however, information is needed regarding whether providers perceive such tools to be useful for addressing nutrition and physical activity lifestyle behaviors.

Objectives This study aimed to evaluate the usefulness and usability of FitTastic, an EMR-enabled tool to support prevention and management of childhood obesity in primary care.

Methods In this mixed-method study, we implemented the FitTastic tool in two primary-care clinics, then surveyed and conducted focused interviews with providers. Validated Technology Acceptance Model perceived usefulness and National Aeronautics and Space Administration (NASA) perceived usability survey questions were e-mailed to 60 providers. In-depth provider interviews with family medicine and pediatric physicians (n = 12) were used to further probe adoption of FitTastic.

Results Surveys were completed by 73% of providers (n = 44). The mean score for FitTastic's usefulness was 3.3 (standard deviation [SD] = 0.54, scale 1–5, where 5 is strongly agree) and usability, 4.8 (SD = 0.86, scale 1–7, where 7 is strongly agree). Usefulness and usability scores were associated with intention to use FitTastic (correlation for both, p < 0.05). Data from provider interviews indicated that useful features of FitTastic included: standardizing the approach to childhood obesity, and facilitating conversations about weight management, without increasing cognitive workload. However, use of FitTastic required more time from nurses to input lifestyle data.

Conclusion FitTastic is perceived as a useful and usable EMR-based lifestyle behavior tool that standardizes, facilitates, and streamlines healthy lifestyle conversations with families. Perceived usability and usefulness scores correlated with provider intention-to-use the technology. These data suggest that EMR-based child obesity prevention and management tools can be feasible to use in the clinic setting, with potential for scalability. Usefulness can be optimized by limiting amount of time needed by staff to input data.

Keywords

electronic health records and systems - infants and children - ambulatory care/primary care - adoption - implementation and deployment

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 2002856 IRB.


 

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