Date of Publication


Project Team

Christina Harlow DNP, FNP-BC, ENP-C; Walter Ziske, Certified Health and Well-being Coach


PURPOSE: Pediatric obesity rates in rural areas of Vermont are double the Healthy Vermonters goal of 8%. Primary care clinicians are critically positioned to implement interventions for pediatric patients who meet obesity criteria. Research suggests that only 10% of pediatric patients who meet obesity criteria are receiving the recommended lifestyle interventions set forth by the US Preventative Task Force Services USPSTF). The purpose of this project was to understand current practice for the screening and management of pediatric obesity in a rural primary care setting.

METHODS: Data was collected via provider surveys and electronic health record reports to gain an understanding of how current practice compared to best practice recommendations published by the American Academy of Pediatrics (AAP), CDC, and USPSTF.

RESULTS: Data showed that 99.1% (n=1,292) of pediatric patients ages 6-17 were screened with an age specific BMI at their annual well child visit. Survey analysis revealed 30% (n=10) of providers reported use of a uniform clinic diagnostic criteria for pediatric obesity. Of children with an age specific BMI ≥ 95th percentile for age and sex, 45.8% (n=1,292) were provided the corresponding diagnostic billing code. 18.1% (n=1,292) of children with BMI above the 95th percentile were provided a referral to a weight management specialist.

CONCLUSION: Findings were used to perform a gap analysis and develop a proposed workflow for the management of pediatric obesity. This proposed workflow and project can be replicated in other rural primary care practices to help improve the management of pediatric obesity per current best practice guidelines.

Document Type



Obesity, BMI greater than 95th percentile

Available for download on Thursday, May 01, 2025