Tanda Rika, Salsberry Pamela
J Pediatr Health Care. 2014 May-Jun;28(3):241-50. doi: 10.1016/j.pedhc.2013.05.009. Epub 2013 Jul 5.
In this study we examined the impact of the Expert Committee Recommendations (ECRs) on childhood obesity preventive care during well-child visits in the United States.
Data from the 2006-2009 National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey-outpatient department were used to examine frequencies of diet/nutrition and exercise counseling during well-child visits by children aged 2 to 18 years. Differences in rates of the counseling before and after the ECRs were made were compared.
Only 37% and 22% of all patients in 2006-2007 and 33% and 18% of all patients in 2008-2009 were provided with diet/nutrition and exercise counseling, respectively. The frequencies of counseling for patients with a diagnosis of obesity showed no change. Socioeconomically disadvantaged children received counseling less frequently after the ECRs were made.
Overall, rates of obesity preventive care were low in all years, with no evidence of improvement after the ECRs were made. Systematic approaches are needed to improve delivery of obesity preventive care irrespective of the socioeconomic backgrounds of children.
在本研究中,我们调查了专家委员会建议(ECR)对美国儿童健康检查期间儿童肥胖预防保健的影响。
使用2006 - 2009年国家门诊医疗护理调查和国家医院门诊护理调查 - 门诊部的数据,来调查2至18岁儿童在儿童健康检查期间接受饮食/营养和运动咨询的频率。比较了ECR发布前后咨询率的差异。
在2006 - 2007年,所有患者中分别只有37%和22%,以及在2008 - 2009年,所有患者中分别只有33%和18%接受了饮食/营养和运动咨询。诊断为肥胖的患者的咨询频率没有变化。在ECR发布后,社会经济弱势儿童接受咨询的频率降低。
总体而言,多年来肥胖预防保健率一直很低,在ECR发布后没有改善的迹象。需要采取系统的方法来改善肥胖预防保健的提供情况,而不考虑儿童的社会经济背景。