As childhood obesity continues to increase, so do the comorbidities and related health issues, putting youth at a greater risk of developing adult-related diseases such as hypertension, Type 2 diabetes, and cardiovascular diseases. Current literature indicates that healthcare organizations have a significant role in the fight against this epidemic, yet most children's hospitals have no policy to accomplish this task. The purpose of this project was to develop a program proposal for a hospital-based, sustainable obesity program that will aid in improving patient and family awareness of the importance of maintaining an ideal body weight to decrease the incidences of obesity-related comorbidities in pediatric patients ages 2-19 with a Body Mass Index (BMI) greater than or equal to 30. Lewin's theory of planned change and the logic model were used as the theoretical framework to guide the change process for this project through its development. To that end, the proposal was accepted at the site by the executive leadership in consideration for full implementation and evaluation. Key stakeholders and content experts were brought together to create the proposal for the program which includes an algorithm to guide care. The results of this project, once adopted will promote positive change in the quality of life, decrease BMI to a healthy limit, improve overall population health, and reduce healthcare expenditure. Additionally, dissemination of results of the project may stimulate changes in other children's hospitals to adopt the measures of care in the fight against childhood obesity, and contribute to social change. .

Since 1980, the obesity rate in children 5 to 11 years of age has increased from 7% to 18%. The lack of structured physical activity and poor dietary habits childhood are primary risk factors for obesity related comorbidities in adulthood. Guided by primary care providers, families can reverse childhood obesity by implementing healthy dietary habits and engaging in structured physical activity. The purpose of this quality improvement project was to develop an evidenced-based policy with procedures to standardize the timely and consistent identification of overweight children at a primary care clinic serving military families. With an emphasis on obesity prevention within families through primary care interventions, the revised health belief model guided the project design. A literature review was conducted in a systematic manner to identify effective strategies and interventions to inform the policy development. Then, the Delphi technique guided a 12-member expert panel to evaluate the policy and procedures in terms of the level of evidence and the implementation plan with the goal of achieving consensus with recommendations for revisions. Consensus was achieved with multiple revisions following the completion of two Delphi rounds. The first panel session (n=12) concluded with a 70% consensus, including recommended revisions to improve the policy implementation. The second panel session (n=12) concluded with 100% consensus for the revised policy. The final policy and procedures addressed the clinical practice gap with a robust process to identify, counsel, and refer overweight children to external specialty programs for obesity management. By intervening to reverse the progression of childhood obesity, this project achieved positive social change at an organization level.