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Understanding knowledge, practices, and barriers in pediatric weight-management: a multisite cross-sectional study of
Joshua S Yudkin1, Kristy Marie Polanco Lima2, Jenny L Cepeda-Marte2
1Texas A&M University, School of Public Health, College Station, TX, USA. yudkin@tamu.edu.
Insights
Pediatric overweight and obesity management in the Dominican Republic shows provider confidence but gaps in knowledge and counseling. Targeted training and family-centered care are crucial for improving care in low-resource settings.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Clinical Practice Guidelines
Background:
- Rising prevalence of pediatric overweight and obesity (OW/OB) in Latin America and the Caribbean.
- OW/OB poses a significant global health challenge, particularly in low- and middle-income countries (LMICs).
Purpose of the Study:
- To assess healthcare providers' knowledge, attitudes, and counseling practices regarding pediatric OW/OB management.
- To identify barriers and facilitators to effective pediatric OW/OB care in a low-resource setting.
Main Methods:
- Cross-sectional study conducted in 15 pediatric clinics in the Dominican Republic (January-March 2025).
- Surveys assessed provider knowledge, attitudes, self-reported counseling behaviors, and perceptions of the clinical environment.
- Descriptive statistics and multivariable regression analyses were employed.
Main Results:
- High provider confidence in diagnosing OW/OB (93.2%) contrasted with knowledge gaps in definition (57.3%-75.3%).
- Inconsistent counseling on family priorities (27.2%) and physical activity (62.1%) during well-child visits.
- High referral rates to dietitians (91.3%) but low rates of consistent follow-up scheduling (51.5%).
Conclusions:
- Significant gaps exist in provider knowledge and counseling practices for pediatric OW/OB.
- Strengthening pediatric obesity management requires targeted training and enhanced support systems.
- Family-centered care approaches are essential in resource-limited settings for sustainable pediatric obesity management.
Background:
Pediatric overweight and obesity (OW/OB) are growing global health concerns, with rapidly increasing prevalence in Latin America and the Caribbean.
Methods:
This cross-sectional study was conducted from January to March 2025 in 15 pediatric clinics in the Dominican Republic. Surveys assessed healthcare providers' knowledge, attitudes, self-reported counseling behaviors, and perceptions of the clinical environment related to pediatric OW/OB management. Descriptive statistics and multivariable regression analyses were used to examine the associations between provider characteristics and management practices.
Results:
Of the 103 respondents, 79.6% were women and 93.2% were attending physicians. Correct identification of clinical OW/OB definitions ranged from 57.3% to 75.3%. Although 93.2% reported being confident in diagnosing OW/OB, only 27.2% consistently asked families about their priorities for healthy living, and 62.1% regularly addressed physical activity during well-child visits. While 91.3% of providers "always" referred patients to a dietician/nutritionist, only 51.5% consistently scheduled follow-up visits.
Discussion:
The findings of this study highlight gaps in provider knowledge and inconsistencies in obesity-related counseling practices during well-child visits. Strengthening pediatric OW/OB management in LMICs will require targeted training and enhanced support systems that promote family-centered care in resource-limited settings.
Impact:
The key message is that pediatric obesity management shows strong provider confidence but clear gaps in knowledge and counseling practices. This article provides the first multisite evidence on pediatric weight-management practices in a low-resource Latin American setting. Highlights discrepancies between confidence and consistent application of lifestyle counseling. Underscores the urgent need for targeted training, family-centered approaches, and system-level support in LMICs to strengthen sustainable pediatric obesity care.
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