About Healthy Ways
Healthy Ways is a family-centered, collaborative and interdisciplinary
program. Our clinic team includes pediatric specialists in medicine, psychology,
nutrition, physical therapy and nursing. Our program is structured, evidence-based
and flexible to accommodate family and individual needs and differences.
Our program consists of two phases. The initial core phase is 16 weeks
long; the child and family have five to six individual visits with the
clinic team during this time. After the initial 16 weeks, the child and
family enter the maintenance phase of the program, which lasts 12 months.
During maintenance, the child and family have clinic visits every three months.
We are glad you are joining us at Children's Hospital in the Healthy
Ways Clinic. From this day forward, you and your family will be a part
of our team! This is going to be a journey that will include an interdisciplinary
team approach to making lifestyle changes with your entire family. It
is important for you to know your role on this team is just as important
as each of ours. We cannot wait to join you as you learn new ways to become
healthier and achieve the goals we set together.
- Sarah White, MS, RD, LDN (Healthy Ways Registered Dietitian)
- Danielle Robinson, PT, DPT (Healthy Ways Physical Therapist)
- Janice Neece, PhD (Pediatric Psychology)
- Yolanda Chen, MD (Pediatric Hospitalist)
Who The Program Is For
The Healthy Ways Clinic at Children's Hospital is open to patients
from 2 to 18 years old who have a BMI of 85% or greater. Patients are
admitted to the clinic through this Healthy Ways Clinic primary care physician
At the initial clinic visit, a pediatrician specializing in weight management
will complete a detailed history and examination focusing on organ systems
affected by obesity. Fasting labs are required prior to the initial clinic
visit. These include glucose, HgA1c, insulin, cholesterol, HDL, LDL, triglycerides,
TSH, AST, and ALT. After reviewing the history, physical exam and lab
results, referrals to appropriate pediatric specialists will be made by
the physician and other team members.
The goal of the Healthy Ways Clinic is to provide complete medical services
for patients with their associated co-morbidities. Patients are frequently
referred to pediatric specialists including Endocrinology, Pulmonology
(including sleep studies), Gastroenterology, Nephrology and Cardiology.
If the primary care referral physician has questions about patient referrals
or questions after the patient has started the Healthy Ways Clinic, the
doctor is always welcome to call the clinic and talk to our physician
or other team members.
What To Expect
Checking In: Your first day is an orientation to the clinic and the staff. It is a time
for us to get to know you and your family. Once you arrive, you will check
in with registration on the 3rd floor of East Tennessee Children's
Hospital. Our waiting room includes lots of activities to keep you busy
during the wait, including a Wii. Our clinic staff will then check your
vital signs, such as blood pressure and heart rate. They will also check
height and weight as well as waist and hip circumference. If you have
not had any lab work done prior to your first appointment, it might be
done that same day. A room will be assigned to you for the day. Expect
to be here from 8 a.m. to 1 p.m. Yes, this is a long day, but this is
the ONLY time throughout the whole program you will have to stay for this
length of time.
Notebook: You will receive a notebook to keep track of all of your information throughout
the program. You will also be given goal sheets for each visit that can
be placed inside the notebook along with a goal calendar you will use
each day. We hope you will personalize it by adding stickers, magazine
clippings and photos to the front and back covers. This will be your guide
through the clinic program.
Who You Will Meet: Each practitioner will spend about an hour with you and your family. The
pediatrician, physical therapist, psychologist and dietitian will each
ask questions about your home life, school, family, friends, meal times,
activities, school events and other topics to gain insight into your world
and interests. The physical therapist and pediatrician will also do physical
evaluations. Based on the information you share with the Healthy Ways
Clinic team, we will assist you and your family on setting goals. The
goals will be personalized to help you and your family make the most progress
in learning and succeeding with positive changes in your lifestyles.
Goals: You will have nutrition, behavior and physical activity goals to work on
between visits. Goals will be added to or modified with each follow-up
visit. The Healthy Ways Clinic team will review the goal calendar with
you at each visit. This calendar makes it easier to track your progress,
and we hope it will motivate you to reach your goals. Another motivational
tool included in clinic is a rewards list. This list is developed by the
patient and family together, following the initial clinic visit. At each
follow-up visit, if goals have been met, the child has the opportunity
to earn something from the rewards list. Rewards are provided by the family
and are non-food related.
Contract: A contract will be presented to you and your parent to sign at the end
of the first day. It states that you promise to work toward meeting the
goals discussed. It also asks you and your family to commit to being at
each visit on time unless there is an emergency that requires rescheduling.
Follow-up: The first follow-up visit will occur two to four weeks after the first
visit. This visit will be in the clinic conference room with the dietitian,
psychologist and physical therapist; the physician is typically not at
the follow-up visits but does attend your 16-week visit and later visits.
Your first follow-up visit will be a time to discuss how you have been
doing since we first met in clinic. We hope all your questions and concerns
will be addressed at each visit and that you and your family find the
time spent focusing on a healthy way of life helpful and valuable.
Mission, Goals and Philosophy
Our mission is to educate, empower and inspire families in a fun and supportive
environment to live a healthy active lifestyle. Our vision is leading
the way to a healthy and active family lifestyle. Children and adolescents
have more positive outcomes when a supportive and active family is involved.
Results from the Healthy Ways Clinic are highly related to the family's
motivation to make change. We value each family's input and believe
working together provides the best results.
Making Healthy Choices for Life Class
Making Healthy Choices for Life (MHCL) is a class that provides an overview
of healthy lifestyle behaviors involving diet and activity. The overview
includes a review of general nutrition principles, a discussion of how
our choices are part of daily life, and suggestions for making healthier
choices. This class focuses on a family-based approach where all family
members are encouraged to make positive changes together. This class is
led by a Registered Dietitian and lasts approximately one hour. Questions
and participation are encouraged throughout the class. Following the class,
staff members are available to answer individual questions.
A large number of the families who participate in the Healthy Ways Clinic
attend the MHCL class before starting the clinic program. All individuals
interested in the Healthy Ways Clinic are strongly encouraged to attend
the MHCL class prior to starting the clinic program. Attending the MHCL
class gives families the opportunity to be put on a cancellation list
for scheduling with the Healthy Ways Clinic.
If interested in signing up for one of the MHCL classes, please contact
your doctor for a referral to the class.
Frequently Asked Questions
Q: Why is an initial assessment by the clinic's psychologist necessary?
A: The initial assessment by a psychologist is necessary to understand
associated issues such as environmental and family influences, behavioral
or mood-related concerns, school performance, social issues and daily
habits and behaviors. Children and teenagers who struggle with obesity
often experience body image concerns, low self-esteem and symptoms of
depression and anxiety; they also are at an increased risk of being teased
and bullied. The psychologist's role in the clinic is to work with
each child and family to help them better understand their current habits
and behaviors and to help them make lifestyle changes that include, but
are not solely limited to, weight management.
Q: Why is a medical exam by the clinic's pediatrician necessary?
A: Childhood obesity is one of the leading causes of diabetes. A number
of other medical conditions such as high blood pressure, elevated lipids
(fats), poor bone health, early onset of cardiovascular (heart) diseases,
liver disease and sleep apnea can be associated with childhood obesity.
A pediatrician trained in working with overweight patients will take a
detailed, focused history, perform a complete exam and arrange for appropriate
referrals if needed.
Q: Does the program offer or prescribe medications for weight loss?
A: No, our program does not offer or prescribe medications to children
and adolescents for weight loss.
Q: What will the child and family learn in the program?
A: Children learn about themselves and their families. Some of the things
they learn include:
how their daily habits and behaviors may be associated with their overall health
how making healthier choices can improve self esteem
how to identify and problem-solve barriers to making healthier daily choices
how to eat appropriate portions
how to read food labels
how to make healthy food choices at home and restaurants
how to balance activity with sedentary time
Q: How much involvement is required of the family?
A: It is difficult to treat childhood disorders without involving the
family. To facilitate change and motivate the child, it is important to
involve the family. It is sometimes difficult to involve the entire family
every session, but it is required that at least one parent or legal guardian
join their child for every session.
In our experience, patients with the greatest involvement and support
from their family are the patients with the greatest short-term and long-term
success. Therefore, the team at the Healthy Ways Clinic strongly encourages
parents (and extended family) to support and be involved in the child's
weight management goals.
Q: Will it be necessary for my child to miss school for appointments?
A: Yes, your child will miss some school for appointments. We understand
that many children do not want to miss school for a variety of reasons.
A child's health is also of the highest priority, and we will provide
a doctor's note for time missed at school.
Q: How can I get my child into the Healthy Ways Clinic?
A: Your child's pediatrician or primary care physician can refer your
family to the Healthy Ways Clinic. Click here to download the Healthy
Ways Physician Referral Form.
Q: Does health insurance cover the Healthy Ways Clinic program?
A: Your health insurance will be billed for the services provided in the
Healthy Ways Clinic program. Many health insurance plans, including commercial/private
plans, cover portions of the Healthy Ways program. In most cases, TennCare
covers the program in full. Every insurance covers different specialty
services; some cover much of the program, while others cover very little.
One insurance plan may cover lab work and appointments with the clinic's
physician and psychologist, while another insurance plan may only cover
lab work and the physician's initial exam. Some insurance plans also
require a pre-authorization.
For these reasons, it is best to consult with your insurance company early
in the program so you can be aware of what coverage you may have and what
you may have to pay out-of-pocket.
Q: What does it cost to participate in the Healthy Ways Clinic?
A: There is not a set, flat fee for children to go through the Healthy
Ways Clinic program. Each child has different needs, which can determine
some of the services needed during the process. In addition, insurance
may cover some portions of the program, so the remaining out-of-pocket
expense for each family is different. The total cost for the program really
is not determined until billing takes place for the specific services
each child receives.
Children's Hospital is flexible with payment options and is happy
to work with families who need to pay their bill on a monthly payment
plan over time, after insurance has paid its share of any bill. If you
view the Healthy Ways program as an investment in your child's and
family's long-term health, you may find the monthly payments quite
For information about billing or for details on setting up a payment plan,
contact the Children’s Hospital Business Office at
865-541-8187. You can also read about our financial assistance program at
Q: How can I donate to support children in need of treatment for childhood obesity?
A: Children's Hospital and the Healthy Ways Clinic are grateful to
those who are interested in financially supporting this program to help
children who need clinic services. To support the clinic, please contact
our Development Department at 865-541-8441 or visit the Giving section
of the Children's Hospital website.