Frequent Questions About HealthWorks!
The HealthWorks! staff at Cincinnati Children's Hospital Medical Center provides answers to frequent questions about the program:
What can be done to help children and adolescents who are overweight?
Research has shown that the most effective way to help children and their families manage weight is through an interdisciplinary family-based approach that includes a medical evaluation, nutrition counseling, involvement in physical activity and guidance for a family to adopt healthier lifestyle behaviors.
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Does Cincinnati Children's have a program like this?
Yes, it is called HealthWorks! Cincinnati Children's has developed a unique multi-phase intervention program for overweight children and adolescents. This program is based on research done by experts in the field of obesity that evaluated the most effective ways to meet the needs of overweight youths and their families.
Eligibility for the HealthWorks! program is based on the following:
- Age (5-19 year olds)
- Body mass index (BMI) > 95th percentile
- Ability to be physically active in some capacity
- Parent or guardian must be able to make the time commitment to attend all appointments with their child
- A referral from your child's physician or family doctor is strongly encouraged
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Does this program use a specific diet?
No. After evaluating each child and their family individually, we identify unhealthy eating behaviors and replace them with healthier ones. The overall goal of HealthWorks! is to lower calorie intake by creating a healthier way of eating with an emphasis on portion-control to manage weight and support growth. Our focus is on making health-promoting changes that last for a lifetime.
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Is physical activity part of the program?
Yes. Our certified health fitness instructor will help each child and their family become more physically active. The children and adolescents in the program are strongly encouraged to attend group physical activity sessions held at the hospital at least once a week. Group exercise sessions by age group are offered every weekday evening.
We will also work with families to encourage more physical activity when at home, and consider other community-based or school-based activity programs that would be fun for your child and provide additional opportunities to be physically active.
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How does my child get started?
If there is a concern about your child being overweight, your child's pediatrician or family doctor is asked to submit a HealthWorks! referral to our office at Cincinnati Children's. A HealthWorks! staff member will then contact you to explain what is involved in the program and review the financial arrangements available that can cover the services offered.
Once your family feels ready to move forward with participating in HealthWorks!, then your child is scheduled for their initial visit with Health Works!. If your family is unsure or not ready to commit to the HealthWorks! program, you can still be scheduled to see only the physician in HealthWorks! to discuss concerns about your child being overweight and determine what weight management options would work best for your family.
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What takes place at the first appointment?
At the first clinic visit, you and your child will meet with our HealthWorks! clinical team comprised of a physician, clinical dietitian, certified health fitness instructor and nurse. During this visit your child's height, weight, blood pressure, waist circumference and body composition measurements will be taken and your child will complete a 400-meter walk test to assess their fitness level. When fasting blood work is obtained prior to the initial visit, the results will be reviewed with the HealthWorks! physician to determine if there are any other medical problems associated with your child being overweight.
In addition, your family is introduced to behavioral intervention strategies that include the use of contracts, setting goals, daily tracking of goals met and use of incentives provided by the family.
You will also receive a standardized set of goals in the areas of nutrition (e.g. healthy beverages; healthier breakfast options), physical activity and family support. Your child will receive a personalized notebook binder to keep track of program materials, behavioral tools, nutrition education and physical activity handouts, and recipes to support the initial goals.
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What happens next during the initial phase of the program?
Here are the clinic visits for the initial phase of the HealthWorks! program:
Phase I - Initial (Duration: 3-4 months)
| Visit Type |
Providers |
Tests / Procedures |
| Initial Assessment (full morining visit) |
Physician |
Blood tests (fasting) |
| |
Registered Dietitian |
BIA (body composition) |
| |
Certified Health Fitness Instructor |
400-meter walk test |
| |
Nurse |
Waist circumference |
5 Follow-up Visits
Preferably scheduled once every 2-3 weeks (afternoon visits)
- #1 (1/2 hour) Registered Dietitian / Nurse
- #2 (1/2 hour) Registered Dietitian / Nurse
- #3 (1/2 hour) Registered Dietitian / Nurse
- #4 (1/2 hour) Registered Dietitian / Nurse
- #5 (1/2 hour) Registered Dietitian / Nurse
| Visit Type |
Providers |
Tests / Procedures |
| Reassessment (2 hrs) |
Physician |
Blood tests (fasting) |
| |
Registered Dietitian |
BIA (body composition) |
| |
Certified Health Fitness Instructor |
400-meter walk test |
| |
Nurse |
Waist circumference |
*Reward for completing initial phase: HealthWorks! t-shirt (provided by the HealthWorks! program)
- Nutrition Intervention
At follow-up visits height and weight measurements are obtained and adherence to the nutrition, physical activity and family support goals set is reviewed. Revisions to the contracted goals are discussed based on level of compliance with behavioral goals, progress made with improvement in weight status and readiness of the family to make additional changes with the child's eating habits and participation in regular physical activity.
- Physical Activity Intervention
Physical activity is an essential part of successful weight management. Our program encourages children and adolescents to attend weekly group exercise sessions in a non-competitive environment. In this structured setting, the child is encouraged to participate in age-appropriate activities and experience the fun of being physically active.
- Reassessment
The reassessment visit is scheduled after your child completes the five follow-up visits. All the tests and procedures done at the initial visit will be repeated. Your child receives a progress report that summarizes the changes experienced with weight status and body composition, along with changes in other health indicators, such as blood pressure, lab values, and fitness measures. At this visit, a plan will be developed for ongoing care that takes into consideration progress made during the initial phase of the HealthWorks! program.
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What happens after you complete the initial phase?
After completing the initial phase, your child has the opportunity to participate in the Ongoing Intervention phase. A plan will be developed for ongoing care that takes into consideration progress made during the initial phase of the HealthWorks! program.
Phase II - Ongoing Intervention (Duration: 6 months)
5 Follow-up Visits:
There are at least 5 visits typically scheduled once a month, but this may vary (i.e. the frequency and / or number of visits) depending on the individual needs of the child or adolescent and the family.
- #1 (1 hr) Registered Dietitian / Nurse
Note: Follow-up visit #1 is longer in order to review current eating habits and develop a new behavioral contract for the start of the next phase.
- #2 (1/2 hr) Registered Dietitian / Nurse
- #3 (1/2 hr) Registered Dietitian / Nurse
- #4 (1/2 hr) Registered Dietitian / Nurse
- #5 (1/2 hr) Registered Dietitian / Nurse
| Visit Type |
Providers |
Tests / Procedures |
| Reassessment (2 hrs) |
Physician |
Blood tests (fasting) |
| |
Registered Dietitian |
BIA (body composition) |
| |
Certified Health Fitness Instructor |
400-meter walk test |
| |
Nurse |
Waist circumference |
*Note: The ongoing intervention phase can be repeated multiple times.
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How much weight will my child lose?
HealthWorks! is not a weight loss program, but rather a weight management program. The amount of weight a child or teen will lose depends on a number of factors. For a child who is still growing, it may be most appropriate to maintain weight and allow the child to "grow into it." For other children it may be more appropriate to achieve weight loss. Factors to consider include age, gender, amount of extra weight carried, level of motivation and commitment and the child's and / or family's expectations. Individual weight management goals are established and reviewed with each family.
The overall outcome goals for HealthWorks! include the following:
- Positive changes in the child's weight status and body composition
- Promoting fat loss while maintaining or increasing muscle
- Improved health as reflected by lab values
- Healthy bood pressure
- Improved fitness level
- Adherence to a healthier lifestyle such as being more physically active and making healthy food choices
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