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Addressing Structural Racism, Bias, and Health Communication as Foundational Drivers of Obesity Proceedings of a Workshop Series (2022) / Chapter Skim
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7 Data-Driven Obesity Solutions and Innovative Approaches
Pages 51-60

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From page 51...
... • Clinical decision support tools directed at patients and clini cians in primary care and other settings have the potential to promote the uptake of effective weight management strategies, such as Food and Drug Administration (FDA) –approved medi cations and metabolic bariatric surgery.
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From page 52...
... First and foremost is that most school-age children are in these settings for 9–10 months of the year. State mandates and school mission statements encompass a variety of health outcomes, including physical activity, Donnelly continued, and research conducted in the past one to two decades has begun to explore potential relationships between physical activity and academic achievement.
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From page 53...
... , which Donnelly's group explored in a 3-year randomized controlled trial of physical activity and academic achievement for students in second and third grades. Donnelly explained that the premise of PAAC was to increase physical activity by using classroom teachers to integrate it into existing lessons.
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From page 54...
... He argued that additional evidence linking physical activity and fitness with academic achievement would also help promote nontraditional physical activity in schools and support policy changes that could lead to more widespread dissemination of programs like PAAC. Shifting back to the challenge of increasing physical activity in schools without decreasing academic instruction, Donnelly provided several suggestions.
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From page 55...
... He expressed skepticism about the level of school support for integrating physical activity, referencing data from the 2016 School Health Policies and Practices Survey indicating that relatively few U.S. school districts require schools to provide regular classroom physical activity breaks (CDC, 2017)
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From page 56...
... To provide context for his discussion of the clinical decision support tool, O'Connor reviewed various strategies used to treat overweight and obesity and their average effects on weight loss. Lifestyle changes and interventions are clearly indicated and important for any patient with a weight-related condition, he began, but he pointed out that the impact of these approaches on weight varies among individuals and in the best cases is about a 5 percent weight loss over 1 year, on average.
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From page 57...
... O'Connor added that the next step for this tool is to promote a shared decision-making process by communicating the benefits and risks of each appropriate weight loss option to both the patient and the primary care clinician. This nonproprietary clinical decision support tool has been in use for about 10 years, O'Connor recounted, and now serves around 3 million patients in 12 medical groups across 10 states.
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From page 58...
... The tool has an additional tab for clinicians, he added, with more information about the estimated risks and benefits of specific options. O'Connor provided several summary points with regard to the use of clinical decision support tools to manage overweight and obesity, which he predicted could promote uptake of effective weight management strategies.
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From page 59...
... Changes in Participation in Physical Activity as Schoolchildren Age Donnelly explained that as grade level increases, changes occur in the types of physical activity that are promoted and selected. He pointed out as an example that the typical approach with elementary school students tends to break down as children enter middle school, as they become selfconscious about doing silly movements that could cause them to sweat or could be difficult to perform in clothing or shoes that may have been selected with fashion rather than comfort in mind.
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From page 60...
... Availability of Clinical Decision Support Systems O'Connor stated that the tool he had discussed is web based and scalable and is available to health care systems at a cost that covers such expenses as installing the tool at the recipient site. In terms of potential for the tool to interface with a learning health care system,2 he explained that if the tool communicates with the EMR and provides decision support at the point of care, the data can be deidentified and archived in a way that provides a roadmap for identifying care improvement opportunities.
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Key Terms

  • decision support
  • clinical decision
  • weight management
  • academic achievement
  • bariatric surgery

  • support tool
  • integrating physical
  • weight loss
  • support tools
  • nontraditional physical

  • increasing physical
  • management strategies
  • metabolic bariatric
  • management options
  • classroom physical

  • effective weight
  • school day
  • clinical domains
  • shared decision
  • academic instruction

  • percent weight
  • promoting nontraditional
  • portland state
  • donnelly explained
  • classroom lessons

  • physically active
  • instruction time
  • behavioral therapy
  • personalized estimates
  • effective strategy


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