Weight and Health Behavior Conversations in Adolescent Primary Care: A Qualitative Examination

Area of Science:

• Pediatric primary care
• Adolescent health
• Weight management

Background:

• Clinical guidelines recommend screening and treatment for youth overweight/obesity.
• Weight stigma and bias negatively impact healthcare delivery for adolescents with high weight status.
• Current training for pediatricians may be insufficient to optimize care for these patients.

Purpose of the Study:

• To explore adolescent, caregiver, and pediatrician perspectives on current care for youth with high weight status.
• To identify gaps in care and training needs for pediatricians.
• To inform the development of improved training programs.

Main Methods:

• Qualitative study involving individual interviews with adolescents (ages 13-17), caregivers, and pediatricians.
• Participants recruited from a Northeastern US hospital-based primary care practice.
• Interviews were transcribed and analyzed using applied thematic analysis.

Main Results:

• Adolescents and caregivers desired weight-specific, patient-centered communication and guidance for pediatricians.
• Pediatricians discussed their approaches to high weight status, identified training gaps, and suggested training components.
• Key themes included communication preferences, patient-centered care, and pediatrician training needs.

Conclusions:

• Adolescent and pediatrician perspectives highlight the necessity for enhanced pediatrician training to improve care for youth with high weight status.
• Findings offer specific guidance for developing patient-centered training focused on health behaviors and weight-related conversations.
• Improved training can help pediatricians meet clinical guidelines and optimize care for adolescents at elevated weight status.