Feasibility of enhancing well‐child visits with family nutrition and physical activity risk assessment on body mass index

OBJECTIVE: Integration of behavioural risk assessment into well‐child visits is recommended by clinical guidelines, but its feasibility and impact is unknown. METHODS: A quasi‐experimental study evaluated the feasibility and effectiveness of risk assessment on body mass index (BMI) at 1‐year follow‐up. Children with assessments (intervention) were compared with those who did not complete assessments (non‐respondent) and those who received standard care (non‐exposed). RESULTS: Analyses included 10,647 children aged 2–9 years (2,724 intervention, 3,324 non‐respondent and 4,599 non‐exposed). Forty‐five per cent of parents completed the assessments. Intervention and non‐respondent groups differed in change in BMI z‐score at 1 year by −0.05 (confidence interval [CI]: −0.08, −0.02; P = 0.0013); no difference was observed with non‐exposed children. The intervention group had a smaller increase in BMI z‐score (0.07 ± 0.63) than non‐respondent group (0.13 ± 0.63). For children with normal weight at baseline, intervention versus non‐respondent groups differed in BMI z‐score change by −0.06 (CI: −0.10, −0.02; P = 0.0025). However, children with overweight at baseline in the intervention versus the non‐exposed group differed in BMI z‐score change (0.07 [CI: 0.02, 0.14]; P = 0.016). When analysed by age, results were similar for 2‐ to 5‐year‐olds, but no differences were found for 6‐ to 9‐year‐olds. CONCLUSION: Automating risk assessment in paediatric care is feasible and effective in promoting healthy weight among preschool but not older children.