Evaluation of Healthcare Organization Based Management Program in Korea - Using Chronic Care Model -

국내 보건의료기관 기반 청소년 비만관리 프로그램 현황 - 만성질환 관리모형을 중심으로 -

  • Go, Dun Sol (Department of Public Health, Graduate School of Korea University) ;
  • Choi, Min Jae (Department of Health Policy and Hospital Management, Graduate School of Public Health, Korea University) ;
  • Hong, Seok Won (National Evidence-based Collaborating Agency) ;
  • Lee, Seon Heui (College of Nursing, Gacheon University) ;
  • Kim, Young Eun (Department of Preventive Medicine, School of Medicine, Kyung Hee University) ;
  • Noh, Jin Won (Department of Healthcare Management, Eulji University, University Medical Centre Groningen, University of Groningen)
  • 고든솔 (고려대학교 보건학협동과정) ;
  • 최민재 (고려대학교 보건대학원) ;
  • 홍석원 (한국보건의료연구원) ;
  • 이선희 (가천대학교 간호대학) ;
  • 김영은 (경희대학교 예방의학교실) ;
  • 노진원 (을지대학교 의료경영학과)
  • Received : 2016.01.22
  • Accepted : 2016.03.21
  • Published : 2016.03.31

Abstract

Obesity of adolescents causes mental and physical problems as well as social problems, which need prevention and management. Although a number of systematic reviews and meta-analyses on obesity programs for adolescents were conducted, there is no study evaluating the programs based on CCM(Chronic Care Model), an organizing framework for improving chronic illness care. This study was conducted to review the features of studies in obesity management programs and interventions of the selected studies were evaluated in terms of inclusion of components of the Chronic Care Model. 4 databases were searched for relevant studies in obesity management programs, which were published from 1994 to 2014 in Korea. Results were analyzed in a qualitative way. 14 studies were satisfied inclusion criteria. The interventions most frequently utilized the elements of self-management support(66.7%) and only 1 of the studies included more than three components of CCM. This study presents the direction of health policies about managements of metabolic syndrome, which means that we identified effective process of the obesity management programs for adolescents in Korea and also this study will be used as a basic information for the development of obesity management program.

Keywords

References

  1. Rexrode KM, Hennekens CH, Willett WC, Colditz GA, Stampfer MJ, Rich-Edwards JW et al. A prospective study of body mass index, weight change, and risk of stroke in women. JAMA 1997;277:1539-1545. https://doi.org/10.1001/jama.1997.03540430051032
  2. Moon KR. Diagnosis and Treatment of Childhood Obesity. Korean J Pediatr Gastroenterol Nutr 1999;2(1):8-20.
  3. Kim ES. Study on construction of obesity management model and developing CD-DOM for primary, middle, and high school students(Mainly primary school as the center). Korea Health Promotion Foundation. 2000.
  4. Kang S, Kim S, Lee J. Prevalence rates and risk factors of overweight and obesity in children and adolescents-using Korean national health and nutrition examination survey 2005 data. Korean Journal of Epidemiology 2008;30(2):188-197. https://doi.org/10.4178/kje.2008.30.2.188
  5. OECD. Obesity update. 2014. Avaliable from:http://www.oecd.org/health/obesity-update.htm
  6. Woo MJ, Lee JY. The mediating effect of body image and the moderating effect of demographic data on psychosocial problems of obese children problems of obese children. The Korea Journal of Counseling. 2007;8(2):.675-690. https://doi.org/10.15703/kjc.8.2.200706.675
  7. Kuhle S, Kirk SF, Ohinmaa A, Veugelers PJ. Comparison of ICD code-based diagnosis of obesity with measured obesity in children and the implications for health care cost estimates. BMC Medical Research Methodology 2011;11(1):173. https://doi.org/10.1186/1471-2288-11-173
  8. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patient with chronic JAMA 2002;288(14):1775-1779. https://doi.org/10.1001/jama.288.14.1775
  9. Sung KS, Yoon YM, K EJ. Meta-analysis of the Effects of Obesity Management Program for Children. Child Health Nursing Research 2013;19(4):262-269. https://doi.org/10.4094/chnr.2013.19.4.262
  10. Ho M, Garnett SP, Baur L, Burrows T, Stewart L, Neva M et al. Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics 2012;130(6):1647-1671. https://doi.org/10.1542/peds.2012-1176
  11. Kim KM, Lim KI, So WY, Park SK, Song W. A meta-analysis of the effects of exercise therapy applied in obesity studies. The Korean Journal of Obesity 2007;16(4):177-185.
  12. Kang SJ, Jung SL. Effect of 12 weeks aerobic exercise on obesity index, insulin resistance, cardiovascular disease risk factors and exercise capacity in obese adolescent. Exercise Science 2010; 19(3): 277-288. https://doi.org/10.15857/ksep.2010.19.3.277
  13. Choi JY, Kwon JH, Lee JH. The effects of a behvior modification program on weight loss in obese children. The Korean Journal of clinical Psychology 2001;20(4):611-623.
  14. An GH. Comparison of Body Composition, physical fitness and lipid profile between obese elementary boys and girls in obesity camp. Korean Society For Early Childhood Physical Education 2013;14(1):7-19.
  15. Hwang EA, Kim SH, Kang HS, Kim JS. Effect of combined exercise on cytokine in relation to cardiovascular disease in obese adolescents. Exercise Science 2012;21(1):31-40. https://doi.org/10.15857/ksep.2012.21.1.31
  16. Park SN, Shin HS, Son JH. The relation on interpersonal relation formation, physical self-perception, and emotion in obese children participating in physical expression activities. Official Journal of the Korean Society of Dance Science 2012;27:95-107.
  17. Kang SH, Shin KO, Park SY, Woo JH. The effects of regulatory exercise on adipokines and inflammatory reaction in type 1 diabetic and obese children. Journal of Life Science. 2010;20:1066-1072. https://doi.org/10.5352/JLS.2010.20.7.1066
  18. Kwak MA, Kim DJ, Byun JS. Effects of Body Weight Control Program Contains Exercise and Auricular Acupuncture on Body Composition, Blood Composition and Physical Ability in Obese Children. The Journal of Korean Acupuncture & Moxibustion Society. 2009;26(2):171-179.
  19. Shin JY, Ha KS, Kim SY, Lee HY, Choi BM, Lee KH. Outcomes of an Community-based Intervention Program for Obese Children. Journal of Korean Society of Pediatric Endocrinology. 2006;11(1): 85-92.
  20. Lee KY, Kim JK, Lee NS, Han JH, Park TJ, Jeon HN. The factors associated with change in percent obesity after obesity treatment among obese children and adolescents. Journal of the Korean Academy of Family Medicine. 2003;24(1): 64-71.
  21. Kim YS, Lee SY, Kim YO. Nutrition education effect in obesity treatment for children. J. Korean Soc. Food Sci. Nutr. 2002;31(6):1011-1017. https://doi.org/10.3746/jkfn.2002.31.6.1011
  22. Park JK, Ahn HS, Lee DH. Effects of step by step diet control program in obese children. J Korean Society for the Study of Obesity. 2001;10(2): 165-173.
  23. Yun Y, Kim K, Park H. Effect of multidisciplinary weight control program on weight and comorbidity in obese adolescents. Journal of Korean Society for the Study of Obesity. 2001;10(4):325-335.
  24. Lee HR, Kang YJ, Shim JY. Development of an OPD-based childhood obesity control program and the effects of its utilization. Journal of the Korean Academy of Family Medicine. 1998;19 (10):787-800.
  25. Ryoo BK, Ji CH. A study on the exercise program effect in children with obesity. Journal of Physical Growth and Motor Development 1997;5: 213-227.
  26. National Health Insurance Service. National Health Screening Statistical Yearbook. 2013.
  27. Ebbedling CE, Pawlak DB, Ludwig DS. Childhood obesity:Public-health crisis, common sense cure. Lancet 2002;360(9331):473-482. https://doi.org/10.1016/S0140-6736(02)09678-2
  28. Lee DW. Improvement program of The school health policy for a student's obesity prevention [PhD thesis]. Chung-buk: Korea National University;2007.
  29. Jacobson D, Gance-Cleveland B. A systematic review of primary healthcare provider education and training using the Chronic Care Model for childhood obesity. Obesity Reviews 2011;12(5): 244-256. https://doi.org/10.1111/j.1467-789X.2010.00789.x
  30. Glasgow RE, Orleans CT, Wagner EH, Curry SJ, Solberg LI. Does the Chronic Care Model serve also as a template for improving prevention? Milbank Quarterly 2001;79(4):579-612, 2001. https://doi.org/10.1111/1468-0009.00222
  31. Laws R. A new evidence-based model for weight management in primary care: the Conterweight Proramme. Journal of Human Nutrition and Diabetics 2004;17(3):191-208. https://doi.org/10.1111/j.1365-277X.2004.00517.x
  32. Kim KH, Chung BY, Byun HS. The effects of weight control program on body composition, blood pressure, serum lipid and self-regulation behavior in obese college women. Journal of Korean Academy of Adult Nursing. 2007;19(3): 339-352.
  33. Lee DH. Assessment and treatment of childhood obesity. Korean Journal of Pediatrics 1996;39(8): 1055-1065.
  34. Colvin R, Olson S. A descriptive analysis of men and women who have lost significant weight and are highly successful maintaining the loss. Addictive Behavior 1983;.8:287-296. https://doi.org/10.1016/0306-4603(83)90024-2
  35. Medonca P, Altman K. Treatment of overweight children: the relationship between dependent measures and a clinically significant outcome. Journal of Behaviour Assessment 1982;4:187-203. https://doi.org/10.1007/BF01321264
  36. Duffy G, Spence SH. The effective of cognitive self-management as an adjunct to a behavioural intervention for childhood obesity: a research note. Journal of Child Psychology and Psychiatry 1993;36(6):1043-1050.
  37. A. Frank,"A multidisciplinary approach to obesity management: the physicianʼs role and team care alternativesˮ, Journal of the American Dietetic Association, Vol.98, No.10, pp.44-48, 1998. https://doi.org/10.1016/S0002-8223(98)00013-3
  38. P. J. Kaboli, A. B. Hoth, B. J. McClimon and J. L. Schnipper, "Clinical phharmacists and inpatient medical care: a systematic reviewˮ, Archives of Internal Medicine, Vol.166, No.9, pp.955-964, 2006. https://doi.org/10.1001/archinte.166.9.955
  39. M. W. Rich, V. Beckham, C. Wittenberg, C. L. Leven, K. E. Freedland, and R. M. Carney,"A multidisciplinary intervention to prevent the readmission of elderly patients with congestive hear failureˮ, New England Journal of Medicine, Vol.333, No.18, pp.1190-1195, 1995. https://doi.org/10.1056/NEJM199511023331806
  40. Lee KW. Diabetes and Clinical Practice : Appropriate obesity drugs treatment. Korean Journal of Medicine 2009;77(4):971-976.
  41. Wagner EH. The role of patient care teams in chronic disease management. BMJ 2000;320 (7234):569. https://doi.org/10.1136/bmj.320.7234.569
  42. Lee JH. Strategies to strengthen primary care for the efficiency and equity of health care in Korea. Jounral of the Korean Medical Association 2013;56(10):853-855. https://doi.org/10.5124/jkma.2013.56.10.853
  43. Harvey EL, Glenny AM, Kirk SF, Summerbell CD. A systematic review of interventions to improve health professionals' management of obesity. International journal of obesity 1999;23(12): 1213-1222. https://doi.org/10.1038/sj.ijo.0800932
  44. McDonald CJ, Hui SL, Smith DM, Tierney WM, Cohen SJ, Weinberger M, McCabe GP. Reminders to physicians from an introspective computer medical record: a two-year randomized trial. Annals of Internal medicine 1984;100(1):130-138. https://doi.org/10.7326/0003-4819-100-1-130
  45. Rogers JL, Haring OM, Wortman PM, Watson RA, Goetz JP. Medical information systems: assessing impact in the areas of hypertension, obesity and renal disease. Medical Care 1982;20(1):63-74. https://doi.org/10.1097/00005650-198201000-00005
  46. JO MW. The direction of the management business of new chronic disease in which the primary care on the base. Research Institute for Healthcare Policy Korean Medical Association 2014;12(1):36-41.
  47. Jacobson DA. A primary care school age healthy choices intervention program. Arizona State University Dissertation. 2009.
  48. Polacsek M, Orr M, Letourneau L, Rogers V, Holmberg R, O'Rourke K, Hannon C, Lombard KA, Gortmaker SL. Impact of a primary care intervention on physician practice and patient and family behavior: keep Me Healthy-the Maine Youth Overweight Collaborative. Pediatrics 2009;123(5):258-266. https://doi.org/10.1542/peds.2008-2780C
  49. Dennison DA, Yin Z, Kibbe D, Burns S, Trowbridge F. Training health care professionals to manage overweight adolescents: experience in rural Georgia communities. The Journal of Rural Health 2008;.24(1):55-59. https://doi.org/10.1111/j.1748-0361.2008.00137.x
  50. Young PC. Efficacy of a weight management program in overweight children. JAMA 2007;298 (16):1860-1861.
  51. McCallum Z, Wake M, Gerner B, Baur LA, Gibbons K, Gold L, Gunn J, Harris C, Naughton G, Riess C, Sanci L, Sheehan J, Ukoununne OC, Waters E. Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. International journal of obesity 2007;31(4):630-636. https://doi.org/10.1038/sj.ijo.0803509
  52. Cotton B, Smith A, Hansen I, Davis C, Doyle A, Walsh A. Physician-directed primary care intervention to reduce risk factors for Type2 diabetes in high-risk youth. The American journal of the medical sciences 2006;332(3):108-111. https://doi.org/10.1097/00000441-200609000-00002