# Increasing Screening Rates for Comorbidities in Adolescents with Elevated Body Mass Index in Pediatric Primary Care

## TL;DR

This study shows how improving screening rates for health issues in overweight adolescents can help catch problems early and improve long-term health outcomes.

## Contribution

The novel contribution is a successful quality improvement project that increased screening rates using education, decision support, and feedback in pediatric care.

## Key findings

- Screening rates for comorbidities increased from 19.5% to 58% over the study period.
- The improvements were sustained for over three months, indicating lasting impact.
- Many at-risk patients were identified through the enhanced screening process.

## Abstract

Adolescents with elevated body mass index are at increased risk for comorbidities such as dyslipidemia, diabetes mellitus, and metabolic dysfunction-associated steatotic liver disease. Guideline-based screening can identify impacted patients early, allowing for lifestyle modifications and other treatments to improve long-term health. Unfortunately, only 20% of pediatric patients with obesity receive recommended screening.

A multidisciplinary quality improvement team designed and implemented a project to improve comorbidity screening utilizing the Model for Improvement. Provider education and incentive, clinical decision support, and regular performance feedback were chosen as interventions. Screening rates were tracked on a statistical process control chart.

From March through December of 2022, 9547 pediatric patients aged 10 years and up with body mass index greater than or equal to the 95th percentile were seen for preventive care visits. Screening rates for comorbidities increased from a baseline of 19.5%–58% and were sustained for over 3 months. Numerous patients at risk for chronic disease were identified.

Evidence-based clinical decision support, along with provider education and engagement, can effectively increase screening rates for comorbidities in pediatric patients with obesity.