BARRIERS TO TREATMENT AND PREVENTION OF CHILDHOOD OBESITY in RURAL PRIMARY CARE

2.50
Hdl Handle:
http://hdl.handle.net/10755/211507
Type:
Research Study
Title:
BARRIERS TO TREATMENT AND PREVENTION OF CHILDHOOD OBESITY in RURAL PRIMARY CARE
Abstract:
Purpose/Aims:  The purpose of this study was to explore the practices and perceived barriers, resources, and training needs of rural primary care providers as these pertain to prevention, assessment, and treatment of childhood obesity. Rationale/Conceptual Basis/Background:  Childhood obesity is a significant health concern that disproportionately affects rural populations.  Visits to the health care provider offer a key opportunity for identification and treatment of obesity, and for education and counseling concerning nutrition and physical activity.  Yet, despite the existence of clinical guidelines addressing childhood obesity, these have not been consistently translated into practice.  While some barriers to prevention and management of childhood obesity within primary care have been identified, barriers encountered by rural clinicians have not been explored. Methods: Semi-structured interviews were conducted with 13 clinicians (6 physicians, 5 nurse practitioners, and 2 physician assistants), from a total of 35 employed in a pediatric or family practice in a three-county region in rural Oregon.  Interview transcripts were analyzed by two investigators using a modified version of focused coding and grounded theory methods. Results: The majority of clinicians routinely assessed for obesity in pediatric patients.  However, efforts to prevent or treat obesity were limited by time constraints, lack of reimbursement, inadequate patient education materials, lack of parent motivation, the sensitivity of the issue, and clinicians' self-perceived low proficiency in diet counseling and behavior management.  Despite these barriers, clinicians viewed primary care as the “first and last stop” for addressing childhood obesity in these rural counties, where specialists and tertiary weight management centers were inaccessible to much of the population due to distance, low family income, and/or lack of health insurance. Implications: Primary care providers have an essential role to play in preventing and treating childhood obesity within rural communities, where other resources for addressing obesity are often non-existent. Training; clinical aids, such as checklists for assessing diet and readiness to change; and high quality patient education materials are needed to assist clinicians with this responsibility.  Internet or written formats for clinician training are preferred over conferences which usually require considerable travel.  Additionally, alternative approaches, such as employing nurses with expertise in child nutrition and motivational interviewing to lead support groups and counsel families, could be a feasible and cost-effective way to improve the management of childhood obesity within rural primary care.
Keywords:
Obesity; Childhood; Rural Health Services
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
4594
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleBARRIERS TO TREATMENT AND PREVENTION OF CHILDHOOD OBESITY in RURAL PRIMARY CAREen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211507-
dc.description.abstractPurpose/Aims:  The purpose of this study was to explore the practices and perceived barriers, resources, and training needs of rural primary care providers as these pertain to prevention, assessment, and treatment of childhood obesity. Rationale/Conceptual Basis/Background:  Childhood obesity is a significant health concern that disproportionately affects rural populations.  Visits to the health care provider offer a key opportunity for identification and treatment of obesity, and for education and counseling concerning nutrition and physical activity.  Yet, despite the existence of clinical guidelines addressing childhood obesity, these have not been consistently translated into practice.  While some barriers to prevention and management of childhood obesity within primary care have been identified, barriers encountered by rural clinicians have not been explored. Methods: Semi-structured interviews were conducted with 13 clinicians (6 physicians, 5 nurse practitioners, and 2 physician assistants), from a total of 35 employed in a pediatric or family practice in a three-county region in rural Oregon.  Interview transcripts were analyzed by two investigators using a modified version of focused coding and grounded theory methods. Results: The majority of clinicians routinely assessed for obesity in pediatric patients.  However, efforts to prevent or treat obesity were limited by time constraints, lack of reimbursement, inadequate patient education materials, lack of parent motivation, the sensitivity of the issue, and clinicians' self-perceived low proficiency in diet counseling and behavior management.  Despite these barriers, clinicians viewed primary care as the “first and last stop” for addressing childhood obesity in these rural counties, where specialists and tertiary weight management centers were inaccessible to much of the population due to distance, low family income, and/or lack of health insurance. Implications: Primary care providers have an essential role to play in preventing and treating childhood obesity within rural communities, where other resources for addressing obesity are often non-existent. Training; clinical aids, such as checklists for assessing diet and readiness to change; and high quality patient education materials are needed to assist clinicians with this responsibility.  Internet or written formats for clinician training are preferred over conferences which usually require considerable travel.  Additionally, alternative approaches, such as employing nurses with expertise in child nutrition and motivational interviewing to lead support groups and counsel families, could be a feasible and cost-effective way to improve the management of childhood obesity within rural primary care.en_GB
dc.subjectObesityen_GB
dc.subjectChildhooden_GB
dc.subjectRural Health Servicesen_GB
dc.date.available2012-02-20T11:59:11Z-
dc.date.issued2012-02-20T11:59:11Z-
dc.date.accessioned2012-02-20T11:59:11Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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