Childhood Obesity: Knowledge, Attitudes, and Practices of European Pediatric Care Providers

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Health care professionals face problems managing obesity and often fail to follow guidelines for its management in practice. Only a few singlecountry reports are available describing delivery of primary care to children with obesity. WHAT THIS STUDY ADDS:Nearly all primary pediatric care providers from 4 European countries recognize the importance of obesity in pediatric practice, but only half use BMI clinically, and many lack the confidence and the infrastructure needed for providing care to patients with obesity. abstract OBJECTIVE: To determine and compare attitudes, skills, and practices in childhood obesity management in 4 European countries with different obesity prevalence, health care systems, and economic situations. METHODS:A cross-sectional survey was distributed to primary health care providers from France, Italy, Poland, and Ukraine. The questionnaire was returned by 1119 participants with a response rate of 32.4%. RESULTS:The study revealed that most of the primary health care providers were convinced of their critical role in obesity management but did not feel sufficiently competent to perform effectively. The adherence to recommended practices such as routine weight and height measurements, BMI calculation, and plotting growth parameters on recommended growth charts was poor. Most primary health care providers recognized the need for continuing professional education in obesity management, stressing the importance of appropriate dietary counseling. CONCLUSIONS:The study underlines insufficient implementation of national guidelines for management of obesity regardless of the country and its health system. It also makes clear that the critical problem is not elaboration of guidelines but rather creating support systems for implementation of the medical standards among the primary care practitioners. Pediatrics 2013;132:e100-e108 AUTHORS:

Pediatrician-led Motivational Interviewing to Treat Overweight Children: An RCT

“…In fact, screening and tracking BMI percentile according to age and encouraging healthy nutrition and physical activity (PA) are recommended but are not universally delivered in pediatric care. [9][10][11] Although most pediatricians want to prevent obesity, few believe there are any effective treatments once a child is overweight. 9 Practitioners often rely on their professional judgment or on adult diagnostic criteria to identify pediatric obesity because they are unaware of, or lack access to, the appropriate diagnostic tools and guidelines.…”

Exploring nurses’ knowledge and attitudes about children who are overweight/obese: A review of the literature

“…This is supported by a number of authors. [9,10] Goldman, Modan-Moses [9] reported that only 13% of Israeli physicians routinely weighed all children and work in Europe by Mazur, Matusik [10] found only 50.3% of physicians usually calculated children's BMI. Further, Van Gerwen, Franc [11] found only 5% to 33% of clinicians felt competent to manage childhood obesity and Mazur, Matusik [10] reported only 21.4% of physicians felt competent.…”

“…[9,11] Health professionals expressed a high interest in more professional education. [10,13,14] Several studies have shown that one of the barriers for health professionals when providing care to overweight/obese children is parent-related factors, such as the possibility that parents may become defensive and food may be seen as nurturing. [8,14,15] The low rate of measuring children's height and weight may be because it is a sensitive topic to discuss with parents, so GPs only weigh children when they are concerned or parents raise the issue.…”

Low carbohydrate diet and obesity treatment in primary health care: dietary advice after the new Swedish report

“…However, national [10] and international [11][12][13][14] studies have identified obstacles to the implementation of obesity treatment in daily clinical work within primary care. Some of the more common factors described are lack of knowledge [10,13], lack of positive attitude [11][12][13] among the staff working with obese patients, vague guidelines [10,12] and lack of practical descriptions on how to implement the guidelines [12][13][14].…”

“…Some of the more common factors described are lack of knowledge [10,13], lack of positive attitude [11][12][13] among the staff working with obese patients, vague guidelines [10,12] and lack of practical descriptions on how to implement the guidelines [12][13][14]. The choice of treatments offered to patients often depends on local conditions or traditions [13].…”