Derek E Hersch1, Marc James A Uy1, Samantha M Ngaw2, Katie A Loth1. 1. Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA. 2. Entira Family Clinics, Saint Paul, MN, USA.
Abstract
BACKGROUND: Primary care physicians (PCPs) are in a critical position for identifying, preventing and treating childhood obesity. However, a one-size-fits-all approach does not exist for having conversations about weight with families. A better understanding of how PCPs can address paediatric patients' weight concerns is needed in order to develop effective guidelines and trainings. OBJECTIVE: To describe PCPs preferences and behaviours regarding weight-related conversations with paediatric patients' and their families. METHODS: Twenty PCPs affiliated with the University of Minnesota, USA, were recruited to participate in semi-structured interviews. Transcripts were analysed using inductive thematic analysis. RESULTS: PCP's identified well-child visits as the most appropriate time for weight-related discussions with families. Physicians described what approaches/elements they perceived to work best during conversations: collaboration, empathy, health-focused and objective measures. CONCLUSIONS: Overall, PCPs were more comfortable with weight-related discussions during annual well-child visits and rarely initiated them during an acute visit or the first encounter with a patient. Objective measures, such as growth charts, were often utilized to start discussions. Considering a large proportion of well-child visits are missed, alternative opportunities to have discussions about healthy lifestyle behaviours should be explored. The integral role PCPs play in paediatric obesity warrants further research.
BACKGROUND: Primary care physicians (PCPs) are in a critical position for identifying, preventing and treating childhood obesity. However, a one-size-fits-all approach does not exist for having conversations about weight with families. A better understanding of how PCPs can address paediatric patients' weight concerns is needed in order to develop effective guidelines and trainings. OBJECTIVE: To describe PCPs preferences and behaviours regarding weight-related conversations with paediatric patients' and their families. METHODS: Twenty PCPs affiliated with the University of Minnesota, USA, were recruited to participate in semi-structured interviews. Transcripts were analysed using inductive thematic analysis. RESULTS: PCP's identified well-child visits as the most appropriate time for weight-related discussions with families. Physicians described what approaches/elements they perceived to work best during conversations: collaboration, empathy, health-focused and objective measures. CONCLUSIONS: Overall, PCPs were more comfortable with weight-related discussions during annual well-child visits and rarely initiated them during an acute visit or the first encounter with a patient. Objective measures, such as growth charts, were often utilized to start discussions. Considering a large proportion of well-child visits are missed, alternative opportunities to have discussions about healthy lifestyle behaviours should be explored. The integral role PCPs play in paediatric obesity warrants further research.
Keywords:
Attitude of health personnel; delivery of health care; family practice; paediatric obesity/prevention & control; physician–patient relations; qualitative research
Authors: Tamara Brown; Theresa Hm Moore; Lee Hooper; Yang Gao; Amir Zayegh; Sharea Ijaz; Martha Elwenspoek; Sophie C Foxen; Lucia Magee; Claire O'Malley; Elizabeth Waters; Carolyn D Summerbell Journal: Cochrane Database Syst Rev Date: 2019-07-23
Authors: Daisy Bradbury; Anna Chisholm; Paula M Watson; Christine Bundy; Nicola Bradbury; Sarah Birtwistle Journal: Br J Health Psychol Date: 2018-04-26
Authors: Emma Mead; Tamara Brown; Karen Rees; Liane B Azevedo; Victoria Whittaker; Dan Jones; Joan Olajide; Giulia M Mainardi; Eva Corpeleijn; Claire O'Malley; Elizabeth Beardsmore; Lena Al-Khudairy; Louise Baur; Maria-Inti Metzendorf; Alessandro Demaio; Louisa J Ells Journal: Cochrane Database Syst Rev Date: 2017-06-22
Authors: Kyung E Rhee; Stephanie Kessl; Sarah Lindback; Marshall Littman; Robert E El-Kareh Journal: BMC Health Serv Res Date: 2018-01-30 Impact factor: 2.655