scholarly journals Provider views on childhood obesity management in primary care settings: a mixed methods analysis

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Kyung E. Rhee ◽  
Stephanie Kessl ◽  
Sarah Lindback ◽  
Marshall Littman ◽  
Robert E. El-Kareh
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Childhood Obesity ◽  
Obesity Management ◽  
Primary Care Settings

Cooperation behaviour of primary care paediatricians: facilitators and barriers to multidisciplinary obesity management

2020 ◽  
Vol 30 (3) ◽  
pp. 407-414
Author(s):  
Franca Brüggen ◽  
Paul Gellert ◽  
Nadja-Raphaela Baer ◽  
Birgit Jödicke ◽  
Jana Brauchmann ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Health Care Professionals ◽  
Missing Values ◽  
Inpatient Rehabilitation ◽  
Female Gender ◽  
Structural Factors ◽  
Obesity Management ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Multidisciplinary management of obesity by primary care paediatricians, providing a promising approach to tackle childhood obesity includes cooperation with other health care professionals. However, facilitators for and barriers to multidisciplinary cooperation in ambulatory care are not yet well understood and are investigated in the present study. Methods A nationwide, cross-sectional survey of 83% of German primary care paediatricians was conducted, using a questionnaire based on qualitative expert interviews. Frequency of paediatricians’ cooperation with external partners (i.e. nutrition counsellors; sports groups; interdisciplinary obesity centres; inpatient rehabilitation centres; and endocrinologists) was assessed. Individual and structural factors were associated with cooperation patterns. Missing values were addressed using multiple imputation. Results Out of the 6081 primary care paediatricians approached, 2024 (33.3%) responded. Almost half of the respondents (40.8%) stated that they disengaged in the field of obesity prevention due to perceived inefficacy. Lack of financial reimbursement for consultation was agreed on by most of the respondents (90.4%). Identified barriers to cooperation included: higher proportion of patients with migration background, lack of time and available services. A more comprehensive conception of the professional role regarding overweight prevention, higher age, female gender, higher proportion of overweight/obese patients and practice location in urban or socially strained areas surfaced as facilitators for cooperation. Conclusion Low-perceived self-efficacy in obesity management and insufficient financial reimbursement for consultation are commonly stated among German paediatricians. For cooperation behaviour, however, other individual and structural factors seem to be relevant, which provide indications on how multidisciplinary childhood obesity management can be improved.

Burden of child and adolescent obesity on health services in England

2017 ◽  
Vol 103 (3) ◽  
pp. 247-254 ◽  
Author(s):  
Russell M Viner ◽  
Sanjay Kinra ◽  
Dasha Nicholls ◽  
Tim Cole ◽  
Anthony Kessel ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Young People ◽  
Secondary Care ◽  
Service Use ◽  
Lifestyle Modification ◽  
Glycated Haemoglobin ◽  
Obesity Management ◽  
Care Assessment ◽  
The Uk

ObjectiveTo assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England.DesignPathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data.SettingData on CYP aged 2–18 years from the Health Survey for England 2006 to 2013.Main outcome measuresClinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99.86th centile); family history of cardiovascular disease or type 2 diabetes; obesity comorbidities defined as primary care detectable (hypertension, orthopaedic or mobility problems, bullying or psychological distress) or secondary care detectable (dyslipidaemia, hyperinsulinaemia, high glycated haemoglobin, abnormal liver function).Results11.2% (1.22 million) of CYP in England were eligible for primary care assessment and for community lifestyle modification. 2.6% (n=283 500) CYP were estimated to be likely to attend primary care. 5.1% (n=556 000) were eligible for secondary care referral. Among those aged 13–18 years, 8.2% (n=309 000) were eligible for antiobesity drug therapy and 2.4% (90 500) of English CYP were eligible for bariatric surgery. CYP from the most deprived quintile were 1.5-fold to 3-fold more likely to be eligible for obesity management.ConclusionsThere is a mismatch between population burden and available data on service use for obesity in CYP in England, particularly among deprived young people. There is a need for consistent evidence-based commissioning of services across the childhood obesity pathway based on population burden.

scholarly journals Parents' views and experiences of childhood obesity management in primary care: a qualitative study

2011 ◽  
Vol 29 (4) ◽  
pp. 476-481 ◽  
Author(s):  
K. M. Turner ◽  
C. Salisbury ◽  
J. P. H. Shield
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Qualitative Study ◽  
Obesity Management

scholarly journals Successful childhood obesity management in primary care in Canada: what are the odds?

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1327 ◽  
Author(s):  
Stefan Kuhle ◽  
Rachel Doucette ◽  
Helena Piccinini-Vallis ◽  
Sara F.L. Kirk
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Secondary Prevention ◽  
Weight Management ◽  
Systems Approach ◽  
Primary Care Providers ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
Care Providers ◽  
Obesity Management

Background.The management of a child presenting with obesity in a primary care setting can be viewed as a multi-step behavioral process with many perceived and actual barriers for families and primary care providers. In order to achieve the goal of behavior change and, ultimately, clinically meaningful weight management outcomes in a child who is considered obese, all steps in this process should ideally be completed. We sought to review the evidence for completing each step, and to estimate the population effect of secondary prevention of childhood obesity in Canada.Methods.Data from the 2009/2010 Canadian Community Health Survey and from a review of the literature were used to estimate the probabilities for completion of each step. A flow chart based on these probabilities was used to determine the proportion of children with obesity that would undergo and achieve clinically meaningful weight management outcomes each year in Canada.Results.We estimated that the probability of a child in Canada who presents with obesity achieving clinically meaningful weight management outcomes through secondary prevention in primary care is around 0.6% per year, with a range from 0.01% to 7.2% per year. The lack of accessible and effective weight management programs appeared to be the most important bottleneck in the process.Conclusions.In order to make progress towards supporting effective pediatric obesity management, efforts should focus on population-based primary prevention and a systems approach to change our obesogenic society, alongside the allocation of resources toward weight management approaches that are comprehensively offered, equitably distributed and robustly evaluated.

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