Bossick Andrew S, Barone Charles, Alexander Gwen L, Olden Heather, Troy Tanya, Cassidy-Bushrow Andrea E
Department of Public Health Sciences, Patient-Engaged Research Center Henry Ford Health System, Detroit, MI 48202, USA.
Department of Pediatric Administration, Henry Ford Health System, Detroit, MI 48202, USA.
J Patient Cent Res Rev. 2017 Summer;4(3):114-124. doi: 10.17294/2330-0698.1444. Epub 2017 Aug 10.
To examine family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit.
Four focus groups with teen patients (n=16), four focus groups with parents (n=15), and one focus group with providers (n=12) were conducted using a structured moderator guide tailored to each specific population. Eligible patients had a well-child visit during the past 12 months and a diagnosis of overweight, obesity, hyperlipidemia, or elevated blood pressure. Parents who attended their child's well-child visit and had a child meeting these same criteria were eligible. Teen focus groups were divided by gender (male/female) and age (14-15y/16-17y). Focus group transcripts were coded for concepts and themes using qualitative data and thematic analysis. Analysis was performed across groups to determine common themes and domains of intersect.
Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Teens did not recognize the health implications from excess weight, and both parents and teens express the need for more information on strategies to change behavior. Providers recognize several challenges and barriers to discussing weight management in the well-child visit.
A clinician-teen-family relationship built on trust, longevity, teamwork, support, and encouragement can create a positive atmosphere and may improve understanding for weight-related messages for teens and families during a well-child visit.
探讨在儿童健康检查期间，家庭（患者及其父母/监护人）和临床医生对于识别及管理肥胖症和肥胖相关病症的偏好。
采用针对每个特定人群量身定制的结构化主持人指南，对四组青少年患者（n = 16）、四组家长（n = 15）以及一组医疗服务提供者（n = 12）进行了焦点小组访谈。符合条件的患者在过去12个月内进行过儿童健康检查，且被诊断为超重、肥胖、高脂血症或血压升高。参加孩子儿童健康检查且孩子符合相同标准的家长也符合条件。青少年焦点小组按性别（男/女）和年龄（14 - 15岁/16 - 17岁）进行划分。使用定性数据和主题分析对焦点小组访谈记录进行概念和主题编码。跨组进行分析以确定共同主题和交叉领域。
青少年和家长期望在儿童健康检查时讨论体重问题，并且更倾向于由一位使用严肃、一致语言的值得信赖的临床医生来进行讨论。青少年并未认识到超重对健康的影响，家长和青少年都表示需要更多关于改变行为策略的信息。医疗服务提供者认识到在儿童健康检查中讨论体重管理存在若干挑战和障碍。
建立在信任、长期关系、团队合作、支持和鼓励基础上的临床医生 - 青少年 - 家庭关系可以营造积极的氛围，并可能在儿童健康检查期间增进青少年和家庭对体重相关信息的理解。
