TY - JOUR
T1 - Adoption of an Electronic Medical Record Tool for Childhood Obesity by Primary Care Providers
AU - Williams, Amy
AU - Turer, Christy
AU - Smith, Jamie
AU - Nievera, Isabelle
AU - McCulloch, Laura
AU - Wareg, Nuha
AU - Clary, Megan
AU - Rajagopalan, Anuradha
AU - Brownson, Ross C.
AU - Koopman, Richelle J.
AU - Hampl, Sarah
N1 - Funding Information:
In addition to the effectiveness and adoption of FitTastic, we assessed its scalability by evaluating its appropriateness and feasibility for expansion into other practices.23 An important factor for scalability feasibility is cost.24 Start-up effort and cost for EMR-based tools can be significant. A 2017 study of a childhood obesity EMR-based decision support tools for provider and self-guided behavior-change support tools for parents was estimated to cost $119 per child or $237 per BMI unit reduced.25 Implementation of FitTastic in our primary care clinics was facilitated by integration of the software in the EMR before our study. EMR companies can assist the implementation of publicly available tools such as FitTastic by embedding them in their software packages. Goal-matched handouts are available and can be provided online through patient portals in English and Spanish. Cost for goal-matched FitTastic incentives varied from $1.12 for each Frisbee to $3 for each water tumbler, which can add a substantial and continued expense. After initial grant funding for this project was expended, additional funding to continue providing FitTastic incentives was provided by the Boone County Public Health and Human Services, demonstrating a strong clinic-community public health partnership.
Funding Information:
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.
Publisher Copyright:
© 2020 Georg Thieme Verlag. All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - 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.
AB - 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.
KW - adoption
KW - ambulatory care/primary care
KW - electronic health records and systems
KW - implementation and deployment
KW - infants and children
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U2 - 10.1055/s-0040-1705106
DO - 10.1055/s-0040-1705106
M3 - Article
C2 - 32187633
AN - SCOPUS:85082023743
SN - 1869-0327
VL - 11
SP - 210
EP - 217
JO - Applied Clinical Informatics
JF - Applied Clinical Informatics
IS - 2
ER -