Division of Adolescent Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
J Am Board Fam Med. 2010 May-Jun;23(3):334-42. doi: 10.3122/jabfm.2010.03.090070.
To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity.
Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006.
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.
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.
探讨家庭医生在使用体重指数（BMI）百分位值筛查儿童超重和肥胖方面的信念和实践。
2006 年，向 1800 名美国家庭医师学会会员邮寄了有关儿童超重管理的调查。
共收回 729 份调查问卷，其中 445 份有效。大多数（71%）成员熟悉 BMI 指南；41%熟悉美国家庭医师学会关于超重的建议。大多数（78%）有计算 BMI 的工具；较少的人有足够的时间进行超重筛查（55%），只有 45%的人报告在为 2 岁以上的儿童进行常规就诊时，最多或每次都计算 BMI 百分位值。使用电子健康记录会增加 BMI 筛查率。家庭医生认为自己能够讨论体重问题，但只有 43%的人认为他们的咨询有效，许多人（55%）缺乏社区或转诊服务。大多数（72%）人希望为患者提供简单的饮食和运动建议。与体重相关的服务报销不足：86%的人表示，患者无法支付未保险覆盖的服务费用。因子分析确定了临床医生的自我效能、资源和报销是与计算 BMI 百分位值相关的因素。
BMI 在家庭医生中未得到充分利用。大多数人认为他们应该尝试预防超重，并拥有使用 BMI 的工具，但临床医生几乎没有治疗资源，自我效能较低，报告报销不足。
