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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Screening and counseling for childhood obesity: results from a national survey
Tracy S Sesselberg1, Jonathan D Klein, Karen G O'Connor
1Division of Adolescent Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Insights
Family physicians underutilize body mass index (BMI) percentiles for childhood overweight screening despite familiarity with guidelines. Lack of resources, time, and inadequate reimbursement hinder effective screening and treatment.
Area of Science:
- Pediatrics
- Family Medicine
- Public Health
Background:
- Childhood obesity is a growing public health concern.
- Early identification through screening is crucial for intervention.
- Family physicians play a key role in pediatric health management.
Purpose of the Study:
- To assess family physicians' knowledge, attitudes, and practices regarding BMI percentile screening for pediatric overweight and obesity.
- To identify barriers and facilitators to BMI percentile utilization in primary care settings.
Main Methods:
- A survey was mailed to 1800 members of the American Academy of Family Physicians in 2006.
- The survey focused on the management of childhood overweight and obesity.
- 445 eligible responses were analyzed.
Main Results:
- Most physicians were familiar with BMI guidelines but less so with specific recommendations for overweight.
- While tools for BMI calculation were available, time constraints and low self-efficacy in counseling effectiveness were reported.
- Electronic health records were associated with higher screening rates, but a lack of treatment resources and inadequate reimbursement were significant barriers.
Conclusions:
- Body Mass Index (BMI) screening for childhood overweight is underutilized by family physicians.
- Physicians express a desire to prevent overweight but face challenges with treatment resources, self-efficacy, and reimbursement.
- Improving resources, reimbursement, and clinician confidence is essential to enhance BMI screening and management.
Purpose:
To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity.
Methods:
Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006.
Results:
729 surveys were returned; 445 were eligible. Most (71%) members were familiar with BMI guidelines; 41% were familiar with American Academy of Family Physician recommendations about overweight. Most (78%) had tools available to calculate BMI; fewer have enough time for overweight screening (55%), and only 45% reported computing BMI percentile at most or every well visit for children older than 2. Having an electronic health record increased BMI screening rates. Family physicians felt prepared to discuss weight, but only 43% believed their counseling was effective and many (55%) lack community or referral services. Most (72%) wanted simple diet and exercise recommendations for patients. Reimbursement for weight-related services is insufficient: 86% say that patients cannot pay for services not covered by insurance. Factor analysis identified clinician self-efficacy, resources, and reimbursement as factors related to calculating BMI percentiles.
Conclusions:
BMI is underutilized by family physicians. Most believe they should try to prevent overweight and have tools to use BMI, but clinicians have few resources available for treatment, have low self-efficacy, and report inadequate reimbursement.
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