Parenting at Mealtime & Playtime Resource Toolkit V2

View a message from Dr. Sarah Adams, PMP Medical Director

What is Parenting at Mealtime and Playtime (PMP)?
  • PMP is a program that’s designed for pediatricians, allied health professionals, families, and children to enhance their skills and knowledge of nutrition, physical activity, and parenting. This program seeks to empower families with children of all ages to take control of their health to improve their long-term wellbeing and live their best lives.
  History and Timeline of PMP
  • PMP was initially developed as a Quality Improvement (QI) project to provide medical professionals with screening tools and resources for their patients. It has since evolved to be an education program that teaches and coaches pediatric healthcare providers across the state of Ohio.
  How to Use This Toolkit
  • This PMP Toolkit is a resource guide to implement the components of PMP into your practice. This resource will help you navigate difficult conversations with your patients and families, set goals, and establish best practices for working with patients of all backgrounds.
  Importance of PMP
  • The PMP program seeks to improve the general health and wellbeing of all children, focusing on obesity prevention, mental health, nutrition, physical activity, and the promotion of optimal health into adulthood.
  • Childhood obesity continues to rise and there is a direct risk of being overweight or obese into adulthood. The prevalence of obesity is 20%, affecting about 14.7 million children and adolescents.
  • Youth are struggling with mental health and a recent study found that overall, 1 out of 5 US children ages 3 – 17 have one or more of the common mental, emotional and behavioral health conditions.
Educational Handouts
  • PMP developed over 50 informational handouts covering various topics related to pediatric health. Please find these handouts here.
Instagram Reels to Share with Families
  • PMP short videos related to the topics in the handouts. Find them here.
Recorded Webinar Trainings
  • PMP provides Continuing Medical Education (CME) and Maintenance of Certification (MOC) Part II credit through online, live webinars. The webinars are recorded and posted here. Healthcare providers may watch the recordings in their entirety and credit can be claimed for up to one year after the live session was recorded.
Mobile Application
  • The PMP Mobile App can be found on the Apple App Story and Google Play App Store by searching “Parenting at Meal and Playtime”, or through this link.
Motivational Interviewing is an evidence-based counseling style that engages patients around health issues and goals. Research on SMART goals has demonstrated value for patients to create healthier habits and better health outcomes. SMART goals focus on creating clear, concise, and patient-centered ambitions by creating an action plan to help them think through a step-by-step process to integrate their goals into daily life. Utilizing SMART goals moves from provider-centered instruction to patient-centered participation and can builds trust and respect between the patient and provider. Christopher Bolling, MD, FAAP, an expert in pediatric obesity medicine, presented Motivational Interviewing webinar to the Ohio AAP; find the recording here.
Questions to Consider When Setting SMART Goals with Your Patients: How to Set SMART Goals with Your Patients:
  1. Set goals that are important to your patient and families.
  2. Set 1 - 2 goals at a time for success; small changes create consistency and may lead to big results.
  3. Create an action plan.
  4. Be sure to discuss “what” and “how” to achieve goals through clear interventions.
  5. Acknowledge that barriers may present themselves and work together to determine what the patient will do if a barrier occurs.
  6. Ask the patient and family about their support system.
  7. Set a time to check in and follow up.
  8. Celebrate all wins.
Marnie Walston, MD presented a training on Navigating Difficult Weight Related Conversations and shared helpful tips for providers working with weight-related concerns.
  1. Improve your knowledge of obesity, treatment, and local referral pathways.
  2. Check biases when caring for children with obesity.
  3. Ask permission before addressing weight.
  4. Use patient-preferred, non-stigmatizing language.
  5. Listen to patients and create individualized care plans.
The recording of this webinar can be accessed here. Share and Use the PMP Mobile App During the Well Child Visit. Components that should be included in the well visit/documented in the chart:
  • Documenting if the child is underweight, healthy weight, overweight or obese
  • Reviewing the child’s growth curve
  • Assessing the growth trajectory pattern- decreased, maintained, increased
  • Assessing family history (diabetes, high blood pressure, hyper lipidemia, heart disease, stroke under 55)
  • Documentation of discussing: age-specific diet anticipatory guidance, age-specific physical activity anticipatory guidance, opportunities to improve the patient’s dietary and/or activity habits
  • Providing a PMP handout or referring to the mobile app
  • Setting a goal
  • Discussing a follow-up plan
Use the Ohio AAP’s Diversity, Equity, and Inclusion Toolkit, linked here, to support Ohio AAP members and non-members to be empowered to enhance their cultural competence and humility and utilize their lived experience to impact outcomes. The Ohio AAP and Parenting at Mealtime and Playtime encourage adoption of inclusive practices that create an atmosphere of respect, equity, and accountability. The DEI Toolkit will expand the knowledge and skills of our membership and partners to bring this to fruition. View our helpful webinars on Body Positivity and Social Determinants of Health.  Working With Uncomfortable or Resistant Patients  Ask open ended questions - use “what”, “how”, “tell” vs questions that only require a yes or no answer, such as “any”, “do”, “can”. For example - “What is one habit if you could change you would?
  1. Empathize and name the emotions they are having - “It sounds like you are having a difficult time around this”; “I would be upset if that happened to me too” Use PEARL statements, found below.
  2. Practice reflective listening - Reflective listening involves letting patients express their thoughts and then, instead of telling them what to do, capturing the essence of what they have said and helping them arrive at an idea for change. For example, “What I hear you saying is that fast food is easier when you have a busy day? What are some healthier options where you usually go?”
  3. Make a plan that is good for all - keep it patient centered, acknowledging barriers and providing support.
PEARLS:
  • Partnership: “I know we both want what’s best. We may disagree on how to achieve it, but I know we’re in this together.
  • Empathy: “This has been a really tough conversation for you, I can see that.”
  • Apology and Acknowledgement: “I’m sorry this can’t be easier for us right now.”
  • Respect: “Your expertise is valuable in this situation; I know you know yourself better than I do.
  • Legitimization: “Anyone would feel angry (disappointed, exhausted, etc.) in that situation”
  • Support: “We are going to work together on this.”
Visit the PMP page on the Ohio AAP’s website to explore more of our resources and materials designed to support you in providing optimal care.
For questions, comments, or concerns, reach out to the Parenting at Mealtime and Playtime program manager, Suhavi, at ssr@ohioaap.org.