Chris Foley

70 statements · 2 topics

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you need to get attached with them. Um, know that your obesity contact may reside in many different divisions. It could be in Gedes, endocrine, GI, cardiology, psychology. It could be in a lot of different places. So you have to, you have to keep looking around at your tertiary care facilities when you need help.

quote · Obesity

our message from the section on obesity is, you know, we're gonna have to act a lot more like internists as we go through this process because our kids are developing comorbidities. We need to be equipping ourselves with, with expertise and how to handle this.

quote · Obesity

you're gonna come to like, OK, here's a patient coming through foster care or at school who is morbidly, morbidly obese, and you don't know what to do with them in your office. So it's really important to have a tertiary care connection.

quote · Overweight

what I'll do is I'll kind of talk with them about those, those, uh, uh, I have a goal sheet that I present to the families and let them sort of pick with where they wanna go

quote · Overweight

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Chris's statements about Obesity 35 statements

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The Right Tool for the Job: Child & Adolescent Obesity 2015

Quotation I have no financial relationships to disclose with any of the things that I'm going to talk with you about today. Um, I will not discuss off-label uses, but, um, I will discuss commercially available products and a heck of a lot of other things from nonprofit sites. So I will name names. Open

Quotation this kind of talk is useless if I talk in generalities. So I will name particular products. I just want you guys to know I have no relationship with these whatsoever. Open

Statement The 2007 AAP guidelines form the basis for the algorithm and framework for obesity prevention and treatment tools. Open

Statement Obesity treatment exists on a spectrum from prevention and healthy lifestyle promotion on one end to surgical intervention and treatment failure on the other, with practice interventions and community interventions in between. Open

Quotation We really think about obesity treatment as a spectrum. Everything from prevention and healthy lifestyle promotion on the left side of your screen all the way over to surgical intervention and possibly treatment failure on the right side of the screen with everything a little bit in between Open

Quotation where you as a practice shake out depends on several factors, depends on. The time you have to allot to this kind of endeavor, um, the kinds of resources you have, the needs of your community, etc. Open

Statement The obesity care pyramid has progressively fewer patients at each higher level but requires increasingly detailed interventions: base (at-risk only), then higher risk, overweight, obese, and severely obese at the top. Open

Quotation it's fewer and fewer numbers of people as we work our way up the pyramid, but they require more and more detailed types of interventions. Open

Statement Obesity is affected by multiple levels of the socio-ecological model: individual behavior, interpersonal networks, organizational structures (school, work), community, and public policy. Open

Statement Let's Go (letsgo.org) from Maine, created by Tory Rogers and John Fanberg with community partners, is where 5-2-1-0 messaging originated and provides toolkits, posters, logos, and handouts for office-based prevention. Open

Statement The AAP's Pediatric e-Practice (PEP) at pep.aap.org is a joint product with the Institute for Healthy Childhood Weight that organizes resources by virtual office rooms (exam room, waiting room, billing office) with patient education materials, coding information, and work-site wellness resources. Open

Statement Healthy Active Living for Families (HALF) on healthychildren.org provides nutrition guidance for all families with a strong obesity prevention message, organized by age with sections on food/feeding, physical activity, and parenting tips. Open

Statement Quality improvement collaboratives (national, state, regional, citywide) help practices hone obesity prevention strategies while earning maintenance of certification credit. Open

Statement Motivational interviewing is the foundational counseling approach for pediatric weight management; training can be obtained through schools of public health, nursing, health education, or motivationalinterviewing.org, and does not need to be weight-specific. Open

Statement Cognito's Change Talk is a free app and desktop resource for pediatric obesity-specific motivational interviewing training, developed with Bob Schwartz from the Section on Obesity executive committee. Open

Statement Motivational interviewing addresses the 'why' of behavior change while cognitive behavioral therapy (CBT) strategies address the 'how'; elements of CBT are helpful when doing weight management. Open

Statement Content should be personalized with your own office logo and vernacular, and should make sense locally for your patients rather than referencing resources that don't exist in your community. Open

Quotation It's really important that your content, it makes sense locally for your patients. There's a lot of national stuff, but the more you can make it local and personal, the better. Um, it really, you know, it doesn't do any good to say that like, oh well, Boys and Girls Clubs have this program if there are no Boys and Girls Clubs in your neighborhood. Open

Statement ChooseMyPlate.gov provides tear-off sheets of the MyPlate graphic and the SuperTracker tool, which allows families to track physical activity and food, and find recipes. Open

Statement ChopChop magazine (chopChopmag.org), created by the Institute for Healthy Childhood Weight and New Balance Foundation, promotes fruit and vegetable intake based on the message that kids are more likely to eat if they are active participants in food preparation. Open

Quotation don't underestimate the value of social media. You'll find some other really interesting people out there, people that you don't necessarily always agree with. But people that have a lot of good insight on this Open

Quotation The whole, um, the whole, uh, message here is that kids are more likely to eat, um, if they are partic active participants in the pre in the preparation process. Open

Quotation I'm not above encouraging a Fitbit. I'm not above encouraging my watching my having my patients see that I'm watching, that I'm wearing. Um, either a pedometer or an accelerometer. Um, a lot of times when they see it hanging on my wrist and I wear it proudly, it then opens up the door for me to talk about, you know, 10,000 steps Open

Statement Fitness trackers (Fitbit, pedometers, accelerometers) and apps (MyFitnessPal, Lose It) are appropriate tools to encourage for certain families; wearing one visibly as a provider opens the door to discuss 10,000 steps and daily physical activity. Open

Statement For severely obese patients with significant comorbidities, primary care providers need to expand care to include comorbidity management and may need to interpret elevated hemoglobin A1C, blood sugar, or abnormal lipid profiles themselves. Open

Quotation our message from the section on obesity is, you know, we're gonna have to act a lot more like internists as we go through this process because our kids are developing comorbidities. We need to be equipping ourselves with, with expertise and how to handle this. Open

Statement Pediatricians will need to act more like internists as children develop obesity-related comorbidities, requiring training in comorbidity management. Open

Quotation you need to get attached with them. Um, know that your obesity contact may reside in many different divisions. It could be in Gedes, endocrine, GI, cardiology, psychology. It could be in a lot of different places. So you have to, you have to keep looking around at your tertiary care facilities when you need help. Open

Statement Obesity contacts at tertiary care centers may reside in multiple divisions including GI, endocrine, cardiology, psychology, not just one location. Open

Statement Maine's Next Steps program has 17 behavioral goals; Dr. Foley uses an adapted version focusing on 8 core goals including the 5-2-1-0 behaviors plus restricting eating out to 3 times per week, portion control, healthy snacks, and eating a healthy breakfast. Open

Statement Dr. Foley's practice uses a 'Basic Training' program for families interested in obesity treatment, delivered by physicians, nurse practitioners, and physician assistants, using materials like the 5-2-1-0 clinical decision support flip chart. Open

Quotation what I'll do is I'll kind of talk with them about those, those, uh, uh, I have a goal sheet that I present to the families and let them sort of pick with where they wanna go Open

Quotation it's like, you know, it's like all of us, uh, you know, after you do a few ear infections, you know how to prescribe amoxicillin. After you do have a few kids who say, I really wanna talk about how I can change my fruit and vegetable intake, you're gonna have your talking points. Open

Statement The Children's Hospital Association website maintains a list of programs that conform to CHA recommendations for pediatric obesity care. Open

Quotation you're gonna come to like, OK, here's a patient coming through foster care or at school who is morbidly, morbidly obese, and you don't know what to do with them in your office. So it's really important to have a tertiary care connection. Open

Chris's statements about Overweight 35 statements

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