Sustainability of key Maine Youth Overweight Collaborative improvements: a follow-up study.

BACKGROUND Primary care is an opportune setting to contribute to obesity prevention and treatment. However, there is limited evidence for effective and sustainable interventions in primary care. The Maine Youth Overweight Collaborative (MYOC) successfully affected office systems, provider behavior, and patient experience. The current study evaluates the effect of MYOC on provider knowledge, beliefs, practices, patient experience, and office systems, in 2012, three years postintervention. METHODS A quasi-experimental field trial was used with all seven original MYOC intervention sites that participated in MYOC between 2004 and 2009 and two non-MYOC control sites. Data from immediately post-MYOC in 2009 served as the baseline comparison. Main outcome measures included rates of recording of BMI percentile in chart, weight classification, use of the 5210 behavioral screening tool, parental reports of counseling received on 5210 topics, and clinician reports of changes in knowledge, beliefs, and practices. RESULTS Many key MYOC improvements were sustained or improved 3 years postintervention and demonstrated improvements, as compared to control sites. CONCLUSION In an environment where obesity has become a priority for healthcare providers and systems, we demonstrate sustainable improvements in clinical decision support and family management of risk behaviors within a primary-care-based approach to addressing overweight risk among children and youth. Some declines were observed for more-complex behavioral and system outcomes. Many opportunities for office system and provider improvements remain.