Children's Hospitals Today - Spring 2018 - 6

ROUNDS / INNOVATION

Changing the conversation about obesity
A program to encourage healthy behaviors in kids spreads to the adult population.
BY AMANDA BERTHOLF

n the early 2000s, when Tory Rogers,
M.D., was working in the primary care clinic at The Barbara Bush
Children's Hospital (BBCH) in Portland,
Maine, she began noticing more patients were coming in with weight
issues. "At the time, I was interested
in quality improvement work, lead
screening, asthma-I didn't know what
to do," she says. "I didn't know how to
talk to them, what labs to get or if their
weight was a problem."
When Rogers and her team started
looking at the patient population in
the electronic medical record, they
noticed numerous patients with excess
weight issues. Maine has a population
of 1.3 million people, which includes
about 280,000 kids. "In pediatrics, we
all know each other," she says. When
she talked to her colleagues across the
state about their patients with weight
issues, they told her they were experiencing the same thing.
With help from the Maine Center
for Public Health, Rogers and colleagues from 11 pediatric practices
across Maine took action. In 2004, they

or more fruits
and veggies

started a group that developed mesabout it. The whole message shifts the
saging for patients around the concept
emphasis away from weight to behavof 5-2-1-0, which became the foundaiors, and that's an easier conversation
tion for Let's Go!, a childhood
for everyone to have."
obesity prevention program.
News of the program
Let's Go! uses evidencespread across the state.
based strategies to increase
In 2006, 15 other pediatric
healthy eating and physical
practices wanted to join the
of parents are
activity among children from
initiative. Rogers also pilotaware of the
program
birth to age 18. "At the time I
ed the program at her kids'
thought, 'We have a cute messchool. "We found the message we'll use for a few years,
sages resonated in schools
and I'll go back to working on
and were easily delivered
another quality improvement
by a teacher, principal and
project,'" says Rogers, the
school nurse," she says.
of Let's Go! sites
limited or eliminated
medical director of the Let's
Rogers says a strong
sugary drinks
Go! program at BBCH. "I had
evaluation strategy and a
no idea we'd be continuing to
sociological model is helping
evolve 14 years later."
measure what's happening at
This
simple
message
the nearly 1,400 participating
crossed literacy, culture and
sites across Maine today, inyears after the
multidisciplinary lines in
cluding pediatric clinics, child
program started,
the health care setting. "I
care programs and more than
obesity rates
could talk about 5-2-1-0 even
half of the public schools. "We
flattened
though I was never trained
look at behaviors-if kids are
in nutrition and didn't know about
changing, and they are," she says. "If a
nutrition," she says. "My assistant
child goes to a Let's Go! school, he or she
could talk about it; my nurse could talk
is eating more fruits and veggies than a

hours or less
of recreational
screen time

Talking points

The concept of 5-2-1-0 is focused on healthy behaviors,
not obesity, which helps the message resonate.

CHILDREN'S HOSPITAL S TODAY Spring 2018

hour or more
of physical
activity

sugary drinks,
more water

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