Pediatric Residency Obesity and Overweight Training Curricula: A Systematic Review

Silber, Molly; Weiss, Lindsay; Sharaf, Salma; Wang, Yan; Hager, Erin R.; Carter, Rebecca

doi:10.1177/2333794x20928215

Cited by 7 publications

(8 citation statements)

References 20 publications

(71 reference statements)

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“…24,25 This training is not currently universal within paediatric training, but is becoming more commonplace. 26 As such, it is not surprising that residents in our study, who receive training during their outpatient primary care rotations, were more likely to prescribe follow-up compared to the attending physicians. Continued standardization of residency curriculum is needed so that medical providers can learn to approach paediatric overweight and obesity management more systematically, as has been done with other chronic illnesses.…”

Section: Discussionmentioning

confidence: 72%

Giving “prescriptions” for paediatric weight management follow‐up in primary care

et al. 2021

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The American Academy of Paediatrics recommends that primary care paediatricians "prescribe" follow-up for weight management between well child checks. We sought to describe rates and predictors of prescribed and actual clinic attendance for weight management in primary care in a predominantly low-income population. A chart review was performed at a large, hospital-based, primary care clinic, where a treatment algorithm for obesity exists. Eligible children were 6 to 12 years of age with a body mass index (BMI) ≥85th percentile and seen for a well child check in 2014. Primary outcomes were the physician prescribing follow-up in primary care and the patient returning for weight management. Multivariable logistic regression was used to identify predictors of prescribing follow-up and predictors of return. Participants included 1339 patients: mean age 9 years (SD: 1.8 years); 53% female; 79% Black; 89% Medicaid-insured; 56% with an obese BMI (vs overweight). Twenty-seven percent of patients were prescribed follow-up in primary care, of which 13% returned (only 4% of the original sample). The odds of the physician prescribing follow-up were greater if the child had obesity (vs overweight), was older, female or non-Medicaid insured. Older and non-Black patients had greater odds of returning.Patients prescribed follow-up within 2 months or less (vs 3-6 months) were also more likely to return (aOR 2.66; CI: 1.34, 5.26). Rates of prescription for weight management in primary care are low and few patients return, even when follow-up is prescribed. Prescribing follow-up at shorter intervals from the index visit (≤ 2 months) may improve patient return.

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Section: Discussionmentioning

confidence: 72%

Giving “prescriptions” for paediatric weight management follow‐up in primary care

et al. 2021

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“…Many HCPs perceived more problems in talking about weight and lifestyle in cases when parents had overweight or obesity, and/or when they expected the child and/or parent to react negatively. This relates to stigmatization of people with obesity that is present among both the general public and HCPs [20,21], and asks for education in communication strategies to address this sensitive topic [22], thereby improving HCPs' perceived self-efficacy and reducing barriers [2,14,15,23,24]. The majority of doctors (GPs, YHCPs and pediatricians) reported that insufficient time is a barrier to talking about weight and lifestyle.…”

Section: Discussionmentioning

confidence: 99%

“…In other words, SE represents the drive to initiate and adapt behavior, aiming to match one's performance with the circumstances. Accordingly, an increased SE, which can result from training [14][15][16], could help HCPs overcome the barriers they perceive. However, how reported self-efficacy is associated with perceived barriers and the effort to start the conversation has not been studied, and insights into interdisciplinary differences are lacking.…”

Section: Introductionmentioning

confidence: 99%

Talking with pediatric patients with overweight or obesity and their parents: self-rated self-efficacy and perceived barriers of Dutch healthcare professionals from seven disciplines

Voorn

Camfferman

Seidell

et al. 2022

BMC Health Serv Res

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Background Many healthcare professionals (HCPs) feel uncomfortable and incompetent talking about weight with children with overweight and obesity and their parents. To optimally target interventions that can improve obesity care for children, we assessed the self-efficacy (SE) and perceived barriers (PBs) of Dutch HCPs with regard to talking about weight and lifestyle when treating children with overweight or obesity. We also analyzed interdisciplinary differences. Methods A newly developed, practice- and literature-based questionnaire was completed by 578 HCPs from seven disciplines. ANOVA and chi-square tests were used to analyze interdisciplinary differences on SE, PBs, and the effort to discuss weight and lifestyle despite barriers. Regression analyses were used to check whether age, sex or work experience influenced interdisciplinary differences. Results On average, the reported score on SE was 7.2 (SD 1.2; scale 1–10) and the mean number of PBs was 4.0 (SD 2.3). The majority of HCPs (94.6%) reported perceiving one or more barriers (range 0–12 out of 17). HCPs who in most cases perceived too many barriers to discuss weight and lifestyle of the child (9.6%, n = 55) reported a lower SE (mean 6.3) than professionals who were likely to discuss these topics (mean SE 7.3, p < 0.01), despite having a similar number of PBs (mean 4.5 vs 4.0, p > 0.05). In total, 14.2% (n = 82) of HCPs either felt incapable (SE ≤ 5) or reported that in most cases they did not address weight and lifestyle due to PBs. Conclusions Although on average Dutch HCPs rated their self-efficacy as fairly good, for a subgroup major improvements are necessary to lower perceived barriers and improve self-efficacy, in order to improve the quality of care for Dutch children with obesity.

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“…Furthermore, many HCPs perceived more problems in talking about weight and lifestyle in cases when parents had overweight or obesity, and/or when they expected that the child and/or parent would react negatively. This relates to stigmatization of people with obesity that is present among the general public as well as among HCPs (20,21) and asks for education in communication strategies to address this sensitive topic (22), thereby improving HCP's perceived self-e cacy and reducing barriers (2,14,15,23,24). Furthermore, the majority of doctors (GPs, YHCPs and pediatricians) reported that insu cient time is a barrier to talk about weight and lifestyle.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the majority of doctors (GPs, YHCPs and pediatricians) reported that insu cient time is a barrier to talk about weight and lifestyle. This is a commonly reported barrier in other studies as well, and asks also for health delivery system changes (2,14,15,23,24). Next to education, an improved and sustainable nancial and infrastructural framework is necessary to reduce the obesity stigma, improve obesity care for children, and positively impact HCP's perceived self-e cacy and barriers (6,9,20,21).…”

Section: Discussionmentioning

confidence: 99%

Talking with pediatric patients with overweight or obesity and their parents: perceived self-efficacy and barriers of Dutch healthcare professionals from seven different professions. A self-report study

Voorn

Camfferman

Seidell

et al. 2022

Preprint

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Background: Many healthcare professionals (HCPs) feel uncomfortable and incompetent to talk about weight with children with overweight and obesity and their parents. To optimally target interventions that can improve obesity care for children, we assessed the self-efficacy (SE) and perceived barriers (PBs) of Dutch HCPs in regard to talking about weight and lifestyle when treating children with overweight or obesity. In addition, we analyzed interdisciplinary differences.Methods: A newly developed, practice- and literature-based questionnaire was completed by 578 HCPs of 7 different professions. Kruskal-Wallis, t-tests and chi-square tests were used to analyze interdisciplinary differences on SE, PBs and the effort to discuss weight and lifestyle despite barriers. Results: On average for the total group, the reported strength of SE was 7.2 (range 3-10; scale 1-10), and the median number of different PBs was 4.0 (range 0-12; out of 17). The majority of HCPs (94.6%) reported that they perceived one or more barriers.HCPs who perceived too many barriers to discuss the weight and lifestyle of the child in the majority of cases (9.6%), reported a lower SE (mean 6.3), as compared to professionals who were likely to discuss these topics (mean SE 7.3 p < 0.01), although a similar number of PBs. In total, 14.2% (n = 82) of all HCPs either rated their SE below 5 or reported that they did not address weight and lifestyle due to PBs in the majority of cases.Conclusions: Although on average Dutch HCPs rated their self-efficacy fairly good, for a subgroup major improvements are necessary to lower perceived barriers and improve their self-efficacy, aiming to improve the quality of care for Dutch children with obesity.

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Pediatric Residency Obesity and Overweight Training Curricula: A Systematic Review

Cited by 7 publications

References 20 publications

Giving “prescriptions” for paediatric weight management follow‐up in primary care

Giving “prescriptions” for paediatric weight management follow‐up in primary care

Talking with pediatric patients with overweight or obesity and their parents: self-rated self-efficacy and perceived barriers of Dutch healthcare professionals from seven disciplines

Talking with pediatric patients with overweight or obesity and their parents: perceived self-efficacy and barriers of Dutch healthcare professionals from seven different professions. A self-report study

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