Pediatric Healthcare Visits Best Setting for Obesity Prevention; Some Pediatricians Perceive Insufficient Time to Discuss Nutrition and Physical Activity

03/5/2004

PHILADELPHIA, March 5 /PRNewswire/ -- Routine childhood visits to the doctor may be the best occasion to discuss obesity prevention, but many pediatricians may feel too rushed to counsel parents on appropriate nutrition and physical activities. According to a new study, the provider's perception of time inadequacy limits their obesity prevention efforts rather than the actual duration of the visit. Researchers from The Children's Hospital of Philadelphia, the University of Pennsylvania, and the Health Resources and Service Administration (HRSA) presented their findings today at the American Heart Association's Conference on Cardiovascular Disease, Epidemiology and Prevention in San Francisco, Calif.

"Perceived, not actual, time spent with patients is related to obesity prevention counseling," said Shirley Huang, M.D., primary investigator and a nutrition fellow at The Children's Hospital of Philadelphia. "We speculate that busy practitioners can engage in obesity prevention counseling if it is a higher priority than other preventive topics that are covered during a well-care visit."

Researchers hypothesized that adequate well-care visit time was related to more frequent nutrition and physical activity counseling. The researchers provided questionnaires to physicians, nurse practitioners and physician assistants in 30 centers in medically underserved areas of the northeastern U.S. and Puerto Rico. Healthcare providers reported whether they perceived they had adequate time for nutrition and physical activity counseling, as well as reporting actual visit time, dietary assessments and physical activity recommendations.

A total of 181 healthcare providers responded from 26 centers. Results
showed that practitioners assessed diet more often when they perceived they
had adequate time for nutrition counseling as opposed to when they did not. In addition, when they perceived they had adequate time for counseling, providers recommended that children engage in more than 30 minutes of physical activity on most days. There was no association between either diet assessment or physical activity counseling and actual time spent with a patient.

"Preventive education is an important component of lifestyle modification and instilling healthy behavior in young children," said Dr. Huang. "Future research should explore what influences pediatric providers to perceive sufficient time for obesity prevention and thus, to counsel more frequently, regardless of the actual amount of time spent during well-care visits. Continuing medical education should emphasize the importance of nutrition and physical activity counseling during pediatric healthcare visits."

Dr. Huang's co-authors are Kristen L. O'Neill, M.S., and Nicolas Stettler,
M.D., M.S.C.E., of The Children's Hospital of Philadelphia, Shiriki K. Kumanyika, Ph.D., M.P.H., of the University of Pennsylvania, and Steven B. Auerbach, M.D., M.P.H., of the Health Resources and Service Administration.

Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital of Philadelphia is ranked in 2003 as the best pediatric hospital in the nation by U.S. News & World Report and Child magazines. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding among children's hospitals. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents from before birth through age 19. Children's Hospital operates the largest pediatric healthcare system in the U.S. with more than 40 locations in Pennsylvania, New Jersey and
Delaware.

Contact: Joey Marie McCool
(267) 426-6070
McCool@email.chop.edu