An important part of this is that the system surrounding the child is included in the treatment. The first pilots will start at various locations in Limburg from September.
Being overweight among children is a growing problem in the Netherlands, and specifically in Limburg. However, there is no structurally coordinated provision for children who are overweight. Until now, diagnosis and treatment for children with obesity have been available through, among others, a paediatrician, dietitian or physiotherapist. But a permanent central point of contact, coordination of care and an integrated range of support for the family within a network are lacking. At the same time, the social domain often has a clear role to play in the treatment of these children. A structural and effective approach to overweight among children can significantly reduce the risk of chronic diseases later in life.
Coordinated approach focused on the child and their environment
The new innovation policy rule paves the way for a coordinated approach to promoting healthy nutrition, exercise, parenting and psychosocial factors that influence lifestyle, drawing on different disciplines and domains. The programme is tailored to the needs of the child and the family. In addition to lifestyle coaching focused on the child, the programme therefore also explicitly addresses the underlying factors influencing their lifestyle. This requires a connection between the social and healthcare domains.
Medical and social history-taking as the starting point
The approach consists of four components and always begins with a comprehensive assessment by the central care provider. This care provider, who has been specifically trained for this role, not only maps out the health issue but also examines underlying factors that may hinder the effectiveness of lifestyle coaching. A family going through a divorce, poor housing conditions or financial problems are examples that can directly affect the success of a lifestyle intervention for the child. If there are underlying problems, the central care provider can establish a link with possible interventions offered through the social domain. Only once barriers to an effective intervention have been removed does the actual treatment begin through lifestyle coaching. The family is then provided with tailored coaching and support for two years. To maintain the behavioural change initiated and prevent relapse, the programme concludes with a support phase.
Unique collaboration between lifestyle coach and central care provider
The central care provider is the hub for the children and families and ensures the appropriate connection between the medical and social domains. What is special about this approach is that the central care provider is structurally linked to the lifestyle coach, and that, thanks to the innovation policy rule, both are funded under the Health Insurance Act. Applying this policy rule is subject to a number of conditions. For example, municipalities must make resources and capacity available for the necessary interventions in the social domain. There must always be a health insurer that finances the innovation policy rule. VGZ and CZ are financing the pilots in Limburg and are making agreements on this with four regional care groups. Because the innovation policy rule has been formulated in general terms, this approach can also be tested simultaneously in other regions. The results of this experiment could contribute to including this approach in the basic health insurance package.