The Coordination of Care Study

Evaluating Coordination of Care Between Pediatricians and WIC Nutritionists: Early Obesity Prevention for WIC Mothers and Children

• United States Department of Health Resources & Services Administration (HRSA)
• PI: Dr. Jennifer Savage Williams, CCOR

The goal of this study is to build and evaluate a Chronic Care Model for delivering consistent personalized messages to coordinate care across multiple settings- health care clinics and Women Infants and Children (WIC) clinics- to support mothers and children and their related health outcomes.

WIC nutritionists and PCPs face a number of challenges in providing nutrition education, including limited time, resources and training, and the inability to expand services beyond normal hours. Innovative approaches, such as utilizing health information technology (HIT) tools and strategies to coordinate care between providers could reduce confusion and inefficiencies such as addressing conflicts in information and optimize preventive counseling time and effectiveness.

In this study, coordination of care is defined at two levels: (1) PCPs and WIC will deliver the same, consistent messages and (2) providers will communicate with each other on preventive care plans regarding responsive parenting and nutrition education. Our solution-oriented approach aims to coordinate care to optimize parenting education for the primary prevention of early pediatric obesity.

Recently, the "Wee Baby Care Study" team published an article in Translational Behavioral Medicine that presents results from semistructured focus groups of Women, Infants, and Children (WIC) Nutritionists, as well as interviews of pediatricians and parents to evaluate practices, messaging, and the prospect of integrating and coordinating care between the community setting (WIC clinic) and clinical health services (pediatric clinics). Researchers found that stake holders supported sharing health assessment data and integrating health services as strategies to enhance the quality of care, but concerns about security and confidentiality did arise. Overall, integrated, coordinated care was perceived to be an acceptable strategy to facilitate consistent, preventive education and improve patient-centeredness.

Referenced below are papers published from the "Wee Baby" Study:

• Bailey-Davis L, Kling SM, Wood GC, Cochran WJ, Mowery JW, Savage JS, Stametz RA, Welk GJ. Feasibility of enhancing well child visits with family nutrition and physical activity risk assessment on body mass index. Obesity Science & Practice. (2019).
• Savage JS, Kling SM, Cook A, Hess LB, Lutcher S, Marini ME, Mowery J, Hayward S, Hassink S, Hosterman JF, Paul IM, Seiler C, Bailey-Davis L. A Patient-Centered, Coordinated Care Approach Delivered by Community and Pediatric Primary Care Providers to Promote Responsive Parenting: Pragmatic Randomized Clinical Trial Rationale and Protocol. BMC Pediatrics. (2018).
• Bailey-Davis L, Kling SM, Cochran WJ, Hassink S, Hess LB, Franceschelli-Hosterman J, Lutcher S, Marini ME, Mowery J, Paul IM, Savage JS. Integrating and coordinating care between the Women, Infants, and Children Program and pediatricians to improve patient-centered preventive care for healthy growth. Translational Behavioral Medicine. (2018).

Our Wee Baby Study was featured in the Fall 2018 HHD News for Alumni and Friends.