Date of Publication


Project Team

Jean Evelyn Pelski PhD, APRN, NNP-BC, Chayah Lichtig MS, OTR/L


Background: Functional constipation (FC) is a common condition frequently seen in pediatric primary care, with an estimated median prevalence of 16% among pediatric patients (Mugie et al., 2011). Standard care for this condition is typically limited to laxative therapy, however evidence supports improved outcomes for patients who also receive behavioral intervention education. Purpose: The purpose of this quality improvement study was to assess the feasibility of implementing a standardized intervention strategy in a primary care setting for pediatric patients with FC to inform a future pilot study. Methods and interventions: This feasibility study was completed in three steps. 1) A practice gap analysis assessed current practices through data collection on specialist referral sources, consult workflow, and provider experiences with behavioral interventions. 2) A standardized intervention was developed as a clinical reference tool with content from evidence-based behavioral interventions. 3) An implementation strategy was developed and measured utilizing the Implementation Logic Model outcome measurements (Pearson et al., 2020) to assess implementation strategy and overall study feasibility. Results: The majority of specialist referrals came from non-healthcare providers, which may have been due to a cumbersome consult workflow. Most providers reported behavioral interventions were helpful and thought a clinical reference tool would be useful. The implementation strategy satisfied all outcome measurements. Conclusions: Implementation of a standardized intervention strategy was found to be feasible based on study outcomes. It is recommended that a future pilot study use the intervention and implementation strategy described in this study. Introducing a screening for FC is also recommended.

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