PURPOSE: To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity. METHODS: Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006. RESULTS: 729 surveys were returned; 445 were eligible. Most (71%) members were familiar with BMI guidelines; 41% were familiar with American Academy of Family Physician recommendations about overweight. Most (78%) had tools available to calculate BMI; fewer have enough time for overweight screening (55%), and only 45% reported computing BMI percentile at most or every well visit for children older than 2. Having an electronic health record increased BMI screening rates. Family physicians felt prepared to discuss weight, but only 43% believed their counseling was effective and many (55%) lack community or referral services. Most (72%) wanted simple diet and exercise recommendations for patients. Reimbursement for weight-related services is insufficient: 86% say that patients cannot pay for services not covered by insurance. Factor analysis identified clinician self-efficacy, resources, and reimbursement as factors related to calculating BMI percentiles. CONCLUSIONS: BMI is underutilized by family physicians. Most believe they should try to prevent overweight and have tools to use BMI, but clinicians have few resources available for treatment, have low self-efficacy, and report inadequate reimbursement.
PURPOSE: To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity. METHODS: Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006. RESULTS: 729 surveys were returned; 445 were eligible. Most (71%) members were familiar with BMI guidelines; 41% were familiar with American Academy of Family Physician recommendations about overweight. Most (78%) had tools available to calculate BMI; fewer have enough time for overweight screening (55%), and only 45% reported computing BMI percentile at most or every well visit for children older than 2. Having an electronic health record increased BMI screening rates. Family physicians felt prepared to discuss weight, but only 43% believed their counseling was effective and many (55%) lack community or referral services. Most (72%) wanted simple diet and exercise recommendations for patients. Reimbursement for weight-related services is insufficient: 86% say that patients cannot pay for services not covered by insurance. Factor analysis identified clinician self-efficacy, resources, and reimbursement as factors related to calculating BMI percentiles. CONCLUSIONS: BMI is underutilized by family physicians. Most believe they should try to prevent overweight and have tools to use BMI, but clinicians have few resources available for treatment, have low self-efficacy, and report inadequate reimbursement.
Authors: Lauren M Rossen; Yelena N Tarasenko; Amy M Branum; Alan E Simon; Kenneth C Schoendorf Journal: Child Obes Date: 2013-09-12 Impact factor: 2.992
Authors: Xiaozhong Wen; Matthew W Gillman; Sheryl L Rifas-Shiman; Bettylou Sherry; Ken Kleinman; Elsie M Taveras Journal: Pediatrics Date: 2012-04-23 Impact factor: 7.124
Authors: Andrea E Kass; Annie Z Wang; Rachel P Kolko; Jodi C Holland; Myra Altman; Mickey Trockel; C Barr Taylor; Denise E Wilfley Journal: Eat Behav Date: 2014-12-27
Authors: Lisa M Lowenstein; Eliana M Perrin; Marci K Campbell; Deborah F Tate; Jianwen Cai; Alice S Ammerman Journal: Child Obes Date: 2013-05-01 Impact factor: 2.992