has found that HEALTH-COP — the Healthy Eating Active Living TeleHealth Community of Practice — improved health in rural communities throughout California.
Children in small communities are at an increased risk of obesity because they often lack access to healthy foods and a wide range of activities. In turn, obesity puts these kids at risk for diabetes, hypertension, depression and other conditions.
"Obesity prevention and management can be particularly challenging in rural areas," said Ulfat Shaikh, lead researcher, pediatrician and director of Healthcare Quality at the UC Davis School of Medicine. "Families don't have as much access to walking paths, play facilities and places to buy healthy food. There may be only one grocery in town."
To make matters worse, primary care physicians have their own access issues, lacking the peer support that often can lead to better care. Shaikh notes that earlier studies found that access to continuing medical education and peer support were a high priority for doctors in rural communities.
To provide these and other resources, Shaikh and her collaborators created HEALTH-COP, a virtual learning and quality improvement network that reached out to seven clinics throughout rural California. Clinics were located in a variety of settings and served diverse patient populations. For example, one was located in Imperial County, on the California-Mexico border; another was located in Humboldt County nearly the California Oregon border.
Through video conferencing and other methods, rural clinicians learned how to better assess patients' weight; provide counseling on nutrition and physical activity; reorganize clinics to provide better care; screen for risk factors; and implement strategies to effectively discuss body weight.
"Sometimes families broach the issue, but other times they are in denial," said Shaikh. "We provided instruction on motivational interviewing to help change lifestyle behavior. Teams were taught to assess where the family is and help them with their decision making."