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Provider views on childhood obesity management in primary care settings: a mixed methods analysis
Kyung E Rhee1, Stephanie Kessl2, Sarah Lindback2,3
1Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA, 92093, USA. k1rhee@ucsd.edu.
Insights
Pediatric providers face barriers to childhood obesity management, citing lack of time, resources, and confidence. A team-based approach with health educators is recommended to improve care delivery.
Area of Science:
- Pediatric primary care
- Obesity management
- Healthcare systems research
Background:
- Childhood obesity rates remain high, necessitating effective primary care interventions.
- Pediatric providers are crucial for obesity treatment, but current management rates are low.
- Understanding provider perspectives is key to improving pediatric obesity care delivery.
Purpose of the Study:
- To explore pediatric providers' views on childhood obesity management in primary care.
- To identify barriers and facilitators for delivering obesity care.
- To propose effective care models and resources for pediatric obesity management.
Main Methods:
- A mixed-methods approach combining focus groups and surveys.
- Four focus groups conducted with pediatric providers in San Diego County.
- A questionnaire administered to a larger network of providers based on qualitative findings.
Main Results:
- Barriers include provider knowledge gaps, time constraints, lack of resources, and parent-related factors.
- Suggested solutions involve team-based care (case managers, health coaches) and EMR enhancements.
- Only 23.8% of providers desired to conduct behavioral obesity management; health educators were highly requested.
Conclusions:
- Pediatric providers acknowledge the importance of addressing weight but prefer not to manage obesity independently.
- Collaborative care models integrating specialists like health educators are essential for successful pediatric obesity management.
- Future interventions should focus on supportive, team-based strategies within primary care settings.
Background:
Pediatric providers are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. The goal of this study was to examine the views of pediatric providers on conducting obesity management in the primary care setting, and identify potential resources and care models that could facilitate delivery of this care.
Methods:
A mixed methods approach was utilized. Four focus groups were conducted with providers from a large pediatric network in San Diego County. Based on a priori and emerging themes, a questionnaire was developed and administered to the larger group of providers in this network.
Results:
Barriers to conducting obesity management fell into four categories: provider-level/individual (e.g., lack of knowledge and confidence), practice-based/systems-level (e.g., lack of time and resources), parent-level (e.g., poor motivation and follow-up), and environmental (e.g., lack of access to resources). Solutions centered around implementing a team approach to care (with case managers and health coaches) and electronic medical record changes to include best practice guidelines, increased ease of documentation, and delivery of standardized handouts/resources. Survey results revealed only 23.8% of providers wanted to conduct behavioral management of obesity. The most requested support was the introduction of a health educator in the office to deliver a brief behavioral intervention.
Conclusion:
While providers recognize the importance of addressing weight during a well-child visit, they do not want to conduct obesity management on their own. Future efforts to improve health outcomes for pediatric obesity should consider implementing a collaborative care approach.
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