1 National Center for Health Statistics, Centers for Disease Control and Prevention , Hyattsville, MD.
Child Obes. 2013 Oct;9(5):418-26. doi: 10.1089/chi.2013.0051. Epub 2013 Sep 12.
A minority of overweight or obese children are identified as such by a healthcare provider (HCP). The aim of this study was to examine characteristics of caregiver-reported HCP identification of overweight or obesity and whether it is associated with children's waist circumference (WC).
This was an observational study using a nationally representative sample of 14,694 children (2-15 years of age) from the 2001-2010 National Health and Nutrition Examination Survey. Proxy respondents (i.e., caregivers) for 4906 overweight or obese (BMI≥85th percentile) children reported whether an HCP had ever told them that their child was overweight. Multi-variable logistic regression analyses were used to examine associations between reported HCP identification of overweight and child sociodemographic and anthropometric characteristics.
Over 75% of caregivers of overweight or obese children did not recall being notified of their child's weight status by an HCP, though this proportion has decreased over the past decade. A significant WC by weight status interaction indicated abdominal adiposity was positively associated with reported HCP identification for obese children, but not for overweight children.
Lower levels of reported HCP identification were observed for overweight children, compared to obese children; among obese children, those with lower levels of abdominal adiposity were less likely to be identified as overweight by an HCP, according to caregivers. Reasons for this finding remain unclear. Providers may be relying on a child's appearance, rather than universally screening all patients for overweight. Additionally, a variety of parent and provider characteristics may influence weight-related communications and caregiver recall of such information.
少数超重或肥胖的儿童会被医疗保健提供者（HCP）识别出来。本研究旨在检查照顾者报告的 HCP 识别超重或肥胖的特征，以及它是否与儿童的腰围（WC）有关。
这是一项使用来自 2001-2010 年全国健康和营养检查调查的 14694 名 2-15 岁儿童的全国代表性样本的观察性研究。超重或肥胖（BMI≥85 百分位）儿童的代理受访者（即照顾者）报告 HCP 是否曾告诉他们孩子超重。多变量逻辑回归分析用于检查报告的 HCP 识别超重与儿童社会人口统计学和人体测量特征之间的关联。
超过 75%的超重或肥胖儿童的照顾者不记得 HCP 曾通知他们孩子的体重状况，但这一比例在过去十年中有所下降。体重状况与 WC 之间存在显著的交互作用，表明肥胖儿童的腹部肥胖与报告的 HCP 识别肥胖呈正相关，而超重儿童则没有。
与肥胖儿童相比，超重儿童报告的 HCP 识别率较低；在肥胖儿童中，根据照顾者的说法，腹部脂肪含量较低的儿童不太可能被 HCP 识别为超重。这一发现的原因尚不清楚。提供者可能依赖于孩子的外表，而不是普遍筛查所有患者的超重情况。此外，各种父母和提供者的特征可能会影响与体重相关的沟通以及照顾者对这些信息的回忆。
