Posted by anderc8 on Thursday, November 1, 2018 in News, TIPs 2017.

Written by LauraBeth Burgess, RD

Did you know that doctors – on average – spend less than 15 minutes with each patient during their annual visit? That’s about the amount of time it takes to clean up your desk or grab a snack from the cafeteria. The way today’s health care system has evolved results in doctors not spending as much time as they would like to with their patients. Because of this, we need to be intentional in how we spend this time in order to add value to each visit.

There is strong evidence that correlates healthy, physical activity and nutrition behaviors with the prevention and treatment of common chronic diseases including obesity, cardiovascular disease and diabetes – making them incredibly important topics to discuss with your doctor. The question is how to fit these topics into your brief visit with your doctor. The Vanderbilt researchers engaged with the VandyREACH TIPs program are dedicated to addressing these questions.

Our goal is to find reliable and valid screening questions for physical activity and nutrition that will add value to well-child visits or annual adult exams. Below is our method for finding good screening questions and testing them:

1. Literature Search: We began by completing a full literature search to see which existing screening questions were available for physical activity and nutrition. Surprisingly there were few options to choose from. Most screeners were too long to ask in a doctor’s appointment or would not add value to the visit either for the patient or the provider.
2. Interdisciplinary Team Approach: We took our questions to our interdisciplinary team to review value added. Our team includes experts in medicine, law, business, physiology, eduction and dietetics. Questions that would not add value to the appointment were thrown out. For example, asking about vegetable intake seems like a good question, but in a short visit, it might be better to focus on sugary beverages.
3. mTurk Survey: Our grand challenge is to build data-driven behavioral health interventions to improve both individual and population health. By completing the mTurk survey, we were able to look at population health metrics to tie our questions to self-reported outcome measures such as obesity and to check the behavior of the questions (i.e. we know from research that those with higher BMI are more likely to be eating past when they feel full).
4. Cognitive Interviews: We completed cognitive interview with patients and providers to determine usability and value in the individual visit. Would patients be willing to answer these screener questions? Would providers find them helpful and actually use the answers in an individual visit with patients?

Next Steps: We are now utilizing the collected data to choose the best screener questions for physical activity and nutrition for children, adolescents and adults. We plan to include these questions in the electronic health record as a screener questions for annual and well child visits, and we will continue to evaluate the impact both on population health and individual health.