“We Feel Like We Are in It Alone”: A Mixed-Methods Study of Pediatric Primary Care Barriers for Weight Management
- 1 January 2023
- journal article
- research article
- Published by Mary Ann Liebert Inc in Childhood Obesity
- Vol. 19 (1), 3-12
- https://doi.org/10.1089/chi.2021.0274
Abstract
Background: Obesity is a chronic multifactorial disease affecting approximately one in five youth. Many pediatric clinical strategies focus on behavioral change/lifestyle modification efforts, but are limited by their intensity and muted by their inability to address the sociocultural contexts of obesity. The primary objective of the study was to explore primary care pediatric clinicians' current barriers/management practices of patients with obesity. Methods: A mixed-methods study was conducted by distributing an electronic survey to pediatric providers in Washington, DC, and its surrounding metropolitan area. Three focus groups were conducted with a subgroup of these primary care clinicians to further explore their responses. Results: Pediatric clinicians (n = 81) completed the survey out of 380 invitations sent, and 20 took part in 3 focus groups, ranging in size between 4 and 8 clinicians. Over 90% of clinicians felt comfortable advising patients. However, 52% lacked confidence in addressing obesity and over 80% indicated that time constraint is a barrier to care and emphasized the need for more training in obesity management. Six themes emerged regarding clinician barriers to addressing obesity, including (1) limited time, (2) clinician perceived familial resistance, (3) challenges with racial and ethnic concordance, (4) perceived environmental barriers, (5) limited knowledge of community resources, and (6) inadequate collaborative support. Conclusions: Clinicians have difficulty implementing obesity management strategies into their everyday practice due to a variety of barriers. This study emphasized the need for better implementation strategies, tools, and collaboration with community stakeholders for clinicians to engage weight management more effectively.Keywords
This publication has 46 references indexed in Scilit:
- The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical reviewDiabetes, Obesity and Metabolism, 2013
- National survey of US primary care physicians’ perspectives about causes of obesity and solutions to improve careBMJ Open, 2012
- Responding to Pediatric Providers’ Perceived Barriers to Adolescent Weight ManagementClinical Pediatrics, 2012
- Pediatric Residents? Knowledge of the CommunityAcademic Pediatrics, 2012
- Family physician attitudes in managing obesity: a cross-sectional survey studyBMC Research Notes, 2011
- Social prescribing in very deprived areasBritish Journal of General Practice, 2011
- Reducing Childhood Obesity Through Policy Change: Acting Now To Prevent ObesityHealth Affairs, 2010
- Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary ReportPEDIATRICS, 2007
- Social problems, primary care and pathways to help and support: addressing health inequalities at the individual level. Part I: the GP perspectiveJournal of Epidemiology and Community Health, 2007
- Preventing and Treating Obesity: Pediatricians' Self-Efficacy, Barriers, Resources, and AdvocacyAcademic Pediatrics, 2005