Disparities in Nutrition Counseling at Pediatric Wellness Visits in South Carolina

Mandelbaum, Jennifer; Harrison, Sayward E.; Brittingham, Jordan

doi:10.1089/chi.2020.0025

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…be racial disparities, with African American and Hispanic children being less likely to receive counseling than white or non-Hispanic children. 18 Thus, further investigation related to pediatric populations with an IBS diagnosis is an area for future investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, while preliminarily, there appeared to be an overall difference in frequency of recommendations related to nutrition during the initial IBS encounter, this difference was no longer present with removal of the pediatric cohort. Studies investigating patterns of nutrition counseling among children at wellness visits suggest that there may be racial disparities, with African American and Hispanic children being less likely to receive counseling than white or non‐Hispanic children 18 . Thus, further investigation related to pediatric populations with an IBS diagnosis is an area for future investigation.…”

Section: Discussionmentioning

confidence: 99%

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Differences in provider recommendations for Black/African American and White patients with irritable bowel syndrome

Boyd,

Garcia‐Fischer,

Silvernale

et al. 2024

Neurogastroenterology Motil

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BackgroundHealth disparities and barriers to equitable care for patients from racial and ethnic minority backgrounds are common. We sought to evaluate disparities in management recommendations among Black/African American (AA) patients seeking care for IBS.MethodsWe assembled a retrospective cohort of patients at two tertiary care centers who were self‐identifying as Black/AA and attended a first gastroenterology consult for IBS. These patients were age‐ and sex‐matched to White controls with IBS also attending an initial gastroenterology consult. Retrospective chart review determined patient demographics, income, comorbidities, as well as provider management recommendations including pharmacologic therapies and non‐pharmacologic interventions.Key ResultsAmong 602 IBS patients ages 14–88 (M ± SD = 43.6 ± 18.6 years) with IBS, those who identified as Black/AA (n = 301) had a lower estimated mean income and were significantly more likely to have a number of specific chronic medical conditions. Black/AA patients were significantly less likely to have implemented dietary changes for symptoms prior to receiving a diagnosis of IBS from a gastroenterologist. Black/AA patients were also less likely to receive a referral to a dietician within 1 year following their diagnosis of IBS (p = 0.01). Black/AA patients were prescribed pharmacologic therapy more often for constipation (41.9% vs. 34.6%, p = 0.01). It was more common for White patients to present at the initial encounter having already initiated a neuromodulator (41.9% vs. 27.9%, p < 0.001).Conclusion & InferencesManagement recommendations for IBS appear to vary by race, specifically for dietary advice and referrals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Differences in provider recommendations for Black/African American and White patients with irritable bowel syndrome

Boyd,

Garcia‐Fischer,

Silvernale

et al. 2024

Neurogastroenterology Motil

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“…103 There are also disparities in access to intervention services, and when interventions are accessed, they may be less effective. [104][105][106][107] The association between ACEs and obesity in adulthood has been recognized for some time, and an association between ACEs and pediatric overweight and obesity has been identified as well. [108][109][110] Sexual abuse may have a greater effect on obesity than other ACEs, and there seems to be a cumulative effect, such that experiencing multiple ACEs may be associated with increased risk of obesity.…”

Section: Considerations For Multi-component Weight Management Interve...mentioning

confidence: 99%

Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews

Kirk

Ogata

Wichert

et al. 2022

Journal of the Academy of Nutrition and Dietetics

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“…The 2007 Expert Committee recommendations positioned primary care clinicians as part of a collaborative team intended to evaluate children’s obesity-related behaviors, educate them as to healthy habits, and make referrals for additional services, as needed 16 . Despite these clear guidelines, evidence suggests that pediatric primary care clinicians often do not conduct weight assessments or engage pediatric patients and their families in discussions about weight management 17,18 . Although obesity prevention is clearly in the scope of practice of pediatric clinicians, less is known about how clinicians perceive this role, 17 including whether this is and/or should be a primary role, whether there are positive or negative attitudes toward this role, and whether the emphasis on obesity prevention role has shifted over time.…”

mentioning

confidence: 99%

“…16 Despite these clear guidelines, evidence suggests that pediatric primary care clinicians often do not conduct weight assessments or engage pediatric patients and their families in discussions about weight management. 17,18 Although obesity prevention is clearly in the scope of practice of pediatric clinicians, less is known about how clinicians perceive this role, 17 including whether this is and/or should be a primary role, whether there are positive or negative attitudes toward this role, and whether the emphasis on obesity prevention role has shifted over time. Understanding clinician perceptions of their role may be helpful for engaging pediatric primary care clinicians in evidence-based weight management interventions, particularly in areas heavily burdened by childhood obesity.…”

mentioning

confidence: 99%

Primary Care Clinicians’ Perceived Role in Addressing Childhood Obesity in the Southern United States

Mandelbaum¹,

Harrison²

2022

Southern Medical Journal

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Objectives: Primary care is an opportune setting to promote healthy behaviors for children and families. In 2007, an expert committee recommended that pediatric primary care clinicians assess nutrition and physical activity at wellness visits and offer recommendations; however, little is known about what pediatric primary care clinicians perceive their role as in childhood weight management. This qualitative study aimed to describe the perceived role of pediatric primary care clinicians in the prevention and treatment of childhood obesity in South Carolina, a state in the southern United States with high rates of childhood obesity.Methods: Pediatric primary care clinicians (n = 23) from South Carolina were recruited for two focus groups. Participants were asked semistructured, open-ended questions, and audio recordings were transcribed verbatim. Themes and subthemes were identified through an iterative coding and consensus-building process with two coders. Excerpts coded under the parent code of "clinician role" centered on three themes: conducting assessments, making referrals, and providing education.Results: Pediatric primary care clinicians in South Carolina coalesced around the important role of addressing childhood obesity within primary care. Notably, clinicians primarily discussed treatment rather than prevention strategies and described changes in the scope of their practice over time as a result of the increasing numbers of pediatric patients with obesity.Conclusions: Addressing childhood obesity within primary care is a critical component of obesity prevention and treatment in the southern United States. Effective, sustainable prevention and treatment within primary care will depend on the involvement of pediatric clinicians, thus emphasizing the importance of understanding how they perceive their role within this setting.

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Disparities in Nutrition Counseling at Pediatric Wellness Visits in South Carolina

Cited by 6 publications

References 32 publications

Differences in provider recommendations for Black/African American and White patients with irritable bowel syndrome

Differences in provider recommendations for Black/African American and White patients with irritable bowel syndrome

Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews

Primary Care Clinicians’ Perceived Role in Addressing Childhood Obesity in the Southern United States

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