managing pediatric obesity: the benefits of implementing training interventions and obesity-...

Managing Pediatric Obesity:The benefits of implementing training interventions and obesity-specific education to primary care providers.

Racquel Praino · NFS 315 · 5/5/14

Background Information

• Curently 20% to 30% of U.S. 2-19 year olds are either obese or at risk for obesity.

• Obesity: BMI above the 85th percentile for age and gender; a BMI above the 95th percentile.

• This pediatric population are at risk for many comorbid conditions.

Benson L, Baer HJ, Kaelber DC. Trends in the diagnosis of overweight and obesity in children and adolescents. Pediatrics. 123(1).2009.

Barriers of Managing Pediatric Obesity

• Pediatricians not doing BMI assessments of all children.

• Lack of resources; staffing, nutritional specialists.• Time constraints.• Confidence and competence addressing obesity

with children.

Story MT, Neumark-Stzainer DR, Sherwood NE, et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 110:210-214.2002.

How to overcome these Barriers

• Provider training of two 90-minute sessions:1.Providers learn how to help patients manage their w

eight.2.Demonstrate the pros and cons of using a motivation

al interviewing approach to guide behavioral change.

Yarborough BJH, Wu P, Pearson J, Stevens VJ. Responding to Pediatric Providers’ Perceived Barriers to Adolescent Weight Management. Clinical Pediatrics. 2012

Table 2. Pediatric Provider Survey Responses. In: Yarborough BJH, Wu P, Pearson J, Stevens VJ. Responding to Pediatric Providers’ Perceived Barriers to Adolescent Weight Management. Clinical Pediatrics. 51(11);2012.

How to overcome these Barriers

• Development of a step-wise tool kit.• Tool kit will provide guideines to:

• Office-based interventions• Adjusting capabilities of the office• Motivation for the family• Degree of obesity and response to prior intervention

•Increase the number of patient visits.

Hopkins KF, DeCristofaro C, Elliot L. How can primary care providers manage pediatric obesity in the real world? Journal of the American Academy of Nurse Practitioners. 2011; 23:278-288.

Journal of the American Academy of Nurse Practitioners, Jun2011, Vol. 23 Issue 6, p278-288, 11p. Chart; found on p281 part. 1 (Incomplete)

Results of Study 2:• Those with increased doctor’s visits, motivation and beh

avioral interventions produced greater results and most improvement.

• Children who began intervention at a younger age or during the earlier stages of obesity were more likely to continue the programs and increase their chances of success.

Hopkins KF, DeCristofaro C, Elliot L. How can primary care providers manage pediatric obesity in the real world? Journal of the American Academy of Nurse Practitioners. 2011

Conclusion• Providing training interventions and/or guidelines for primary

care providers will:• Increase their comfort in speaking with patients about weight-relate

d issues.• Use office time in a more efficient manor to assess patients.• Help overweight and obese children properly manage their weight a

nd lifestyle, therefore decreases the incidence of comorbid conditions.

• Training could easily be implemented as part of continuing medical education hours to address pediatric obesity.

References:

• Yarborough BJH, Wu P, Pearson J, Stevens VJ. Responding to Pediatric Providers’ Perceived Barriers to Adolescent Weight Management. Clinical Pediatrics. 2012; 51(11):1063-1070.

• Hopkins KF, DeCristofaro C, Elliot L. How can primary care providers manage pediatric obesity in the real world? Journal of the American Academy of Nurse Practitioners. 2011; 23:278-288.