Yarborough Bobbi Jo H, DeBar Lynn L, Wu Philip, Pearson John, Stevens Victor J
Kaiser Permanente Center for Health Research, Portland, OR 97227, USA.
Clin Pediatr (Phila). 2012 Nov;51(11):1063-70. doi: 10.1177/0009922812459269. Epub 2012 Sep 10.
Primary care clinics are an ideal setting for early identification and possibly treatment of adolescent obesity. However, despite practice recommendations promoting preventive screening and monitoring of obesity, implementation has been modest. In this study, we interviewed providers to determine barriers to managing pediatric obesity, perceived skill in obesity interventions, and interest in additional training. The sensitivity of weight-related discussions and time were the 2 most significant barriers reported. We designed a brief training program, implemented it within a larger randomized controlled trial, and surveyed providers regarding its utility. The training was satisfactory to attendees and led to reported changes in practice patterns. Providers who received more complete training reported greater ease working with overweight teens and greater confidence that they could motivate teen patients to make healthy lifestyle changes compared with those who received less training. A fairly modest training intervention could improve patient care in the primary care setting.
基层医疗诊所是早期识别并可能治疗青少年肥胖症的理想场所。然而,尽管有实践建议提倡对肥胖症进行预防性筛查和监测,但实施情况并不理想。在本研究中,我们采访了医疗服务提供者,以确定管理儿童肥胖症的障碍、对肥胖症干预措施的感知技能以及对额外培训的兴趣。与体重相关的讨论的敏感性和时间是报告的两个最主要障碍。我们设计了一个简短的培训项目,在一项更大规模的随机对照试验中实施,并就其效用对医疗服务提供者进行了调查。培训令参与者满意,并导致了报告的实践模式变化。与接受较少培训的提供者相比,接受更全面培训的提供者表示,与超重青少年合作更容易,并且更有信心能够激励青少年患者做出健康的生活方式改变。一项相当适度的培训干预可以改善基层医疗环境中的患者护理。