Child Overweight Interventions in Rural Primary Care Practice: A Survey of Primary Care Providers in Southern Appalachia

Abstract

Child overweight has reached an epidemic level throughout the United States. A total of 65 primary care providers in southern Appalachia were surveyed to understand current issues in addressing child overweight in rural primary care practice. The study shows that while providers realized the importance of child overweight intervention, many were not ready and did little to address child overweight in their practices. The providers' skill levels in addressing child overweight were generally less than sufficient. Common barriers to child overweight treatment included lack of parental motivation and involvement, lack of supportive services, and lack of clinician time. In conclusion, rural primary care is facing many challenges in addressing child overweight. However, with more training in behavioral intervention skills and through establishing a family-based intervention and a group visit approach, primary care providers could play a more active role in the fight against the epidemic of child overweight.

Primary Care Practice Addressing Child Overweight and Obesity: A Survey of Primary Care Physicians at Four Clinics in Southern Appalachia

“…Physicians’ current practices addressing childhood overweight and obesity were assessed with twelve items/activities, using the same questionnaire as the previous study 15. The twelve items are listed in Table 2 and were grouped into three categories: assessment, treatment, and follow-up.…”

“…The Pearson correlation coefficient was calculated between each of the responses, assessment, treatment, and follow-up, and each of the predictors listed on Table 6. The questionnaire items on providers’ attitudes, skill levels, and barriers were adopted from a questionnaire developed by a group of experts consisting of researchers, clinicians, and health educators,11 and are the same as those used in the previous study 15. SPSS ® (SPSS, Inc., an IBM Company, Chicago, IL) software was utilized in the statistical analysis of the data 19…”

“…It is particularly important to understand current perspectives and practices of healthcare providers who may be seeing high rates of overweight and obesity among their patients, but have limited resources for addressing health concerns 14. Furthermore, this study builds upon work in a previous study conducted in 200615 by including pediatricians along with family physicians, and by providing a current assessment of the practices and skill levels of primary care providers pertaining to childhood overweight and obesity. The previous study found that few primary care physicians were ready to assess, treat and monitor childhood obesity.…”

Parent-Led Activity and Nutrition (PLAN) for healthy living: Design and methods

“…Whereas this area has been characterized by a particularly high prevalence of overweight and poor health behaviors [23,24], a recent study revealed only a small portion of primary care providers address these issues in practice [25]. Therefore, designing interventions to meet the needs of providers and individuals in these populations may be especially important.…”

“…The health care provider questionnaire contains 61 items assessing provider’s 1) general demographic information such as gender, education, and years of practice, 2) attitudes toward managing childhood overweight, 3) perceived barriers in the treatment of overweight children, 4) perceived skill level, and 5) readiness in treating child overweight in his/her practice [25, 37]. …”