Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions

Bhuyan, Soumitra S.; Chandak, Aastha; Smith, Patti; Carlton, Erik L.; Duncan, Kenric; Gentry, Daniel

doi:10.1016/j.orcp.2015.07.005

Cited by 23 publications

(22 citation statements)

References 33 publications

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“…They are the reference point for obese children/adolescents and their family, participating in the various proposals for action and decisions, when a more aggressive approach is proposed (e.g., hospitalization or surgery). The efficacy of obesity treatment in the primary care setting is still modest [ 261 , 262 ], but it might improve if pediatricians are assisted by other professionals experienced in pediatric obesity (dieticians/nutritionist, psychologist) and trained in family education and interdisciplinary work [ 258 , 259 , 263 , 264 ] ( LOE VI-B ).…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

et al. 2018

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The Italian Consensus Position Statement on Diagnosis, Treatment and Prevention of Obesity in Children and Adolescents integrates and updates the previous guidelines to deliver an evidence based approach to the disease. The following areas were reviewed: (1) obesity definition and causes of secondary obesity; (2) physical and psychosocial comorbidities; (3) treatment and care settings; (4) prevention.The main novelties deriving from the Italian experience lie in the definition, screening of the cardiometabolic and hepatic risk factors and the endorsement of a staged approach to treatment. The evidence based efficacy of behavioral intervention versus pharmacological or surgical treatments is reported. Lastly, the prevention by promoting healthful diet, physical activity, sleep pattern, and environment is strongly recommended since the intrauterine phase.Electronic supplementary materialThe online version of this article (10.1186/s13052-018-0525-6) contains supplementary material, which is available to authorized users.

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Section: Treatmentmentioning

confidence: 99%

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

et al. 2018

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“…Office and provider based interventions focusing on motivational interviewing and education of families regarding nutrition and physical activity have been shown to be feasible [45] and effective in changing behaviors [38,46]. Reviews of PCP mediated interventions demonstrate that PCP driven obesity treatment can be both successful and sustainable [47].…”

Section: Management and Treatmentmentioning

confidence: 99%

The problem of childhood obesity and the responsibility of primary care providers: a review

Wright¹,

Jones²

2017

Integr Obesity Diabetes

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“…However, active primary care provider (PCP) screening for adolescent obesity was suboptimal in a nationally representative survey in the U.S. in 2011, with less than 50% of PCPs reporting that they assessed BMI with percentiles and 58% indicating that they never or rarely tracked weight over time (Huang et al, 2011; Steeves, Liu, Willis, Lee, & Smith, 2015). In 2014, in another nationally representative survey in the U.S., the majority (97%) of PCPs reported believing they had a responsibility to promote weight management with their patients, but more than half had doubts with their effectiveness to address obesity and more than two thirds felt that they lacked effective strategies (Bhuyan et al, 2015; Steeves et al, 2015). PCP and adolescent sensitivity and discomfort when talking about weight, along with the amount of time needed for those discussions, were the most significant reported barriers to managing overweight or obese adolescents in primary care settings (Bhuyan et al, 2015; Yarborough, DeBar, Wu, Pearson, & Stevens, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…In 2014, in another nationally representative survey in the U.S., the majority (97%) of PCPs reported believing they had a responsibility to promote weight management with their patients, but more than half had doubts with their effectiveness to address obesity and more than two thirds felt that they lacked effective strategies (Bhuyan et al, 2015; Steeves et al, 2015). PCP and adolescent sensitivity and discomfort when talking about weight, along with the amount of time needed for those discussions, were the most significant reported barriers to managing overweight or obese adolescents in primary care settings (Bhuyan et al, 2015; Yarborough, DeBar, Wu, Pearson, & Stevens, 2012). …”

Section: Introductionmentioning

confidence: 99%

Training Primary Care Providers in the Use of Motivational Interviewing for Youth Behavior Change

Vallabhan

Kong

Jimenez³

et al. 2017

Res Theory Nurs Pract

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Background and Purpose Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express discomfort with learning and adopting MI practices and with addressing patient weight issues. PCP proficiency in using MI to discuss body mass index, health screening results, and nutrition and physical activity behaviors after receiving training and coaching from an MI expert and practicing the technique was evaluated. We hypothesized that comfort with MI would increase consistently over time. Methods Self-assessment surveys in MI proficiency were administered to PCPs after every youth participant MI session. MI comfort as determined by proficiency was categorized into low, medium, and high comfort according to survey Likert scale responses. Data were analyzed using ANOVA and Fisher’s exact tests. Results Two hundred twenty-seven youth were seen for MI-based discussions by four PCPs. Two hundred twenty-six surveys had complete data for analysis. As anticipated, overall PCPs reported significantly more comfort with MI from the first to the final MI session over a two to three month period (p < 0.001). Comfort scores did not increase linearly over time for all PCPs. Despite standard training practices, overall MI proficiency as measured by comfort scores varied by PCP (p <0.01). Implications for Practice This type of MI training program should be considered for clinical nurses and nurse practitioners during their nursing education training to facilitate their ability to consistently and effectively support youth behavior change for conditions like obesity. (ClinicalTrials.gov number: NCT02502383)

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Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions

Cited by 23 publications

References 33 publications

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

The problem of childhood obesity and the responsibility of primary care providers: a review

Training Primary Care Providers in the Use of Motivational Interviewing for Youth Behavior Change

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