HeartSmartKids (HSK) in the community

We have been helping clinics and community organizations understand and counsel on the difficult subject of obesity for many years and tens of thousands of visits. Just as HSK helps medical offices implement the assessment and prevention aspects of national guidelines, we can help healthy living organizations:

• implement assessment guidelines on BMI, BP, and lifestyle
• more effectively communicate weight and lifestyle risks to families
• assess lifestyle and deliver recommendations to Spanish-speaking families
• learn and use the techniques of Motivational Interviewing (MI)

SCREENING

The HeartSmartKids kiosk assesses family lifestyle behavior on subjects drawn from the latest research into the causes of childhood obesity. The kiosk can be located anywhere there is an internet connection or even sent via email or text message. Parents or teens can use the interview independently, without the need for staff supervision.

Once a family has completed the interview, they can engage in a discussion of the results with counselors, dietitians, pharmacists, health coaches, or other qualified personnel. The family’s HeartPrint summary can present the screening results for lifestyle factors (e.g. nutrition, activity, smoke exposure), BMI, blood pressure, and family motivation.

Screening Summary - The HeartPrint

The HeartPrint is a compact summary of a child’s cardiovascular risks, and carries many elements to illustrate physical and behavioral risks as well as potential solutions and community resources. A sample HeartPrint summary is shown above. 

Growth - BMI status and trends

The largest element of the HeartPrint is the standard CDC growth charts. These charts indicate how a child’s height, weight, and BMI compare to established growth standards. In addition, the child’s measurements and exact percentiles for height, weight, and BMI are printed at the top of the HeartPrint. A BMI percentile between the 85th and 94th percentile is considered overweight. Above the 95th percentile is considered obese. 

History

The History section of the guidelines refers to gathering an updated family medical history and lifestyle data. This information is collected by the HeartSmartKids kiosk and presented in the top right corner of the HeartPrint. Small heart flags indicate values that exceed guidelines and are good areas to begin lifestyle counseling.

COUNSELING AND PROMOTION OF HEALTHY BEHAVIORS

The basis for prevention and treatment of childhood obesity lies in effective counseling of families to motivate healthy behaviors and connection to healthy resources. National guidelines encourage use of healthy living messages and patient-centered counseling techniques such as Motivational Interviewing (MI). The HeartPrint includes information and tools to help with this challenging task.

Besides the growth page, the HeartSmartKids system produces recommendation pages for both Patient and Counselor. Examples of both pages are shown below.

Patient recommendations

The Patient sheet carries lifestyle information tailored to the family. If the child is overweight or obese, a short note discusses weight status. Following this are recommendations for small steps toward healthier behaviors in nutrition and activity. These recommendations are intended to enhance, not replace, a discussion about the family’s motivations, barriers, and goals.

The patient sheet, along with a copy of the growth charts, is intended to be taken home by the family for goal-setting, self-assessment, and communication with other family members.

Counselor Guidance

A conversation with the family by a qualified employee or volunteer can help motivate families and connect them with possible health resources. The counseling sheet carries information for effective screening, counseling, and referral. This information includes:

• a copy of the recommendations that appeared on the patient sheet. These recommendations will always be in English, even if the patient’s version was in Spanish.
• a summary of the readiness, confidence, and importance answers for effective Motivational Interviewing.
• tips or an outline for implementing the site-specific protocol for counseling families with normal/overweight/obese children.
• information on an overweight/obese referral, if the available.