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Medical staff perceptions regarding pediatric weight management from a low-income community health clinic

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Lauren R. Sastre (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Lauren Haldeman

Abstract: Childhood obesity rates have tripled over the last thirty years and currently one in three children are overweight or obese. Primary care providers identify and provide counseling to parents with overweight and obese children. There is evidence that primary care providers advice is strongly variable, counseling is met by many barriers, and that few providers are familiar with recommended professional guidelines for prevention and treatment of obesity. Additionally, large disparities in pediatric obesity exist, especially within particular minority groups and little is known regarding the perceptions, barriers and strategies of providers working with these groups. In this study medical providers from a diverse, low-income community health clinic (n=32) were interviewed regarding their perceptions, barriers, and strategies in weight management discussions. This sample included: pediatricians, nurse practitioners, registered nurses, certified medical assistants, certified nursing assistants, as well as registered dietitians. Semi-structured interviews were performed in site during working hours, were audio-recorded and transcribed verbatim. Inductive content analysis and open coding were used to analyze transcriptions and identify themes. Themes were identified as weak, consistent or strong. Medical providers in this sample reported being very comfortable discussing weight and initiated conversations by the age of two. A variety of tools were used to initiate conversations and included: growth charts, family history, risk factors, and open-ended questions. Most providers counseling focused on physical activity, some on nutrition and specific advice was found to vary between each provider. Providers rarely observed patient lifestyle changes. The strongest perceived barrier to counseling reported were parents/families with time and culture/language also reported as barriers, however parents were also reported as the strongest influence on patient behaviors. In conclusion, parents may prevent or support counseling efforts and success of weight management by primary care providers.

Additional Information

Publication
Thesis
Language: English
Date: 2012
Keywords
Community, Low-income, Obesity, Pediatric, Perceptions, Physicians
Subjects
Obesity in children
Medical personnel $z North Carolina $x Attitudes
Medical personnel and patient $z North Carolina
Pediatrics $x Social aspects