Centene Center And Health Plan Test New Approach With Childhood Obesity
Initial results of research into the use of peer coaches to manage childhood obesity have been so positive that one Centene health plan has decided to try the approach out for itself. Three MemberConnections representatives (MCRs) at Sunflower Health Plan have been trained by researchers at the Centene Center for Health Transformation™ to work with families on healthy eating and activity interventions in their homes.
Shannon Bohannon, Karen Patterson, and Debbie Weber are already experienced at conducting home visits as part of their MCR role. They educate members on how to manage their conditions, ensure they make doctors’ appointments, and help them access additional health resources. As part of the Raising Well® pediatric obesity program, they will now be interacting with children and families, showing them how to incorporate good eating habits and physical activity into their daily lives.
In addition to lessons on developmentally appropriate nutrition and activity, the MCRs were trained in research protocols, consent procedures, taking height and weight measurements, and engaging families in informative interactive activities. In one, families use a divided plate to demonstrate how to increase their intake of fruits and vegetables and reduce portions. Other activities are designed to get everyone up and moving.
“We try to make it fun,” says Weber. “The idea is to get to know them and not be negative. We are not there to tell them what to do.”
Peer coaching was added to Raising Well’s standard telephonic coaching model as part of an Centene Center study to evaluate whether peers and in-home visits can enhance the coaching experience. With similar backgrounds and experiences to those they visit, the trained peer coaches can develop a different type of relationship with families.
“That’s the biggest thing – establishing trust and a relationship,” says Rachel Tabak, assistant research professor at Washington University in St. Louis, and lead faculty in the Centene Center’s Lifestyle Innovations group. “These families really attach to the educators, so we were attracted to working with MCRs for that reason.”
Initial home visits include an assessment of the home environment and lifestyle behaviors with questions and observations such as:
- Are fruits and vegetables readily available?
- How many sugary beverages are consumed?
- Do family members have meals together?
- How many TV sets are in the household
- How physically active are family members?
A major benefit of in-home visits is objective reporting – the ability to see what’s really going on instead of just relying on what is conveyed. The six-month program calls for monthly contact and three home visits in which the MCRs continue their assessments of family members’ diets and activity levels, take more measurements, and provide ongoing education and motivation.
One measure of success is whether participants stay involved; another is whether they request ongoing support. The home environment is also evaluated throughout to see whether the goal of making healthier behaviors easier was achieved. The ultimate success metric, of course, is achieving sustained lifestyle behavior changes to prevent obesity.
“This is a bonus to be reaching out to members we would not normally be reaching out to,” says Patterson. “Any positive influence in getting kids involved and active is a good thing.”