(EA01-11-25) Harnessing Pediatric Primary Care EHR Data for More Relevant and Timely Surveillance of Obesity Prevalence Trends

Scientific conference where the work was recently presented: AAP National Conference and Exhibition 2024

Date on which the work was previously presented at the scientific conference listed: September 29, 2024

Objectives: Much of what is known about the burden of pediatric obesity is derived from national and state-level surveillance systems. The use of electronic health record data is emerging as an alternative as it offers a low-cost, widely available means of obtaining timely and locally relevant estimates. Our objective was to assess recent trends in obesity prevalence in a single pediatric primary care practice serving a primarily low-income minority population in Georgia and to compare estimates to those from established surveillance systems.

Methods: Data from children aged 2-19 years attending annual well-child visits from 2016 to 2023 were used. Obesity (≥95th BMI-for-age percentile) prevalence was calculated overall and by sociodemographic characteristics for each year, and statistically significant linear trends were assessed across pre-pandemic (2016-2019), pandemic (2019-2021), and post-pandemic (2021-2023) periods. Results were compared against national estimates from the National Health and Nutrition Examination Survey and estimates for the state of Georgia from the National Survey of Children’s Health and WIC Participant and Program Characteristics.

Results: On average, 6,102 patients were seen for well-child visits annually. In 2016, 17.9% of these children had obesity, and prevalence remained stable through 2019. Prevalence increased during the pandemic to a high of 24.0% in 2021. Prevalence has decreased significantly in the post-pandemic period, falling to 21.1% in 2023 (APC=-6.4%, p< 0.001). This trend over time was similar across sociodemographic groups; however, obesity prevalence rates were highest among older children and Hispanic children. Obesity prevalence rates among patients were similar to national estimates obtained in NHANES. Notably, rates among 2-4-year-old patients were lower than those for same age children enrolled in Georgia’s WIC program and rates for the 10-17-year-old patients were significantly higher than the state average for same aged children using NSCH data.

Conclusions: Our results demonstrate the value of using EHR data to complement existing surveillance systems. EHR data can be used to identify and monitor trends in high-risk groups and to guide the development and evaluation of obesity interventions.

Funding Sources: Children's Healthcare of Atlanta