儿童肥胖症的筛查和转介：对美国预防服务工作组建议的依从性。
Screening and Referral for Childhood Obesity: Adherence to the U.S. Preventive Services Task Force Recommendation.
机构信息
Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
出版信息
Am J Prev Med. 2019 Feb;56(2):179-186. doi: 10.1016/j.amepre.2018.10.003. Epub 2018 Dec 17.
INTRODUCTION
The U.S. Preventive Services Task Force recommends clinicians screen children aged 6 years or older for obesity and offer or refer children with obesity to intensive weight management programs. This study explores clinician awareness of weight management programs meeting the recommendation, adherence to the recommendation of screening and referral, and associations between provider and practice characteristics and weight management program referrals.
METHODS
This cross-sectional study used data from the DocStyles survey 2017, a web-based panel survey, analyzed in 2017. Among 1,023 clinicians who see pediatric patients, this study examined clinician awareness of weight management programs in their communities that met the recommendation, practice of screening for childhood obesity, and referral to weight management programs. Multivariable logistic regression estimated associations between the demographic and practice characteristics of clinicians and weight management program referrals.
RESULTS
Only 24.6% of surveyed clinicians were aware of a weight management program that met the U.S. Preventive Services Task Force recommendation in their community; of those aware, 88.9% referred patients to these weight management programs. Most (83.6%) clinicians screened children for obesity in ≥75% of visits. Overall, 53.5% of clinicians provided referrals to weight management programs. Referral was higher among female clinicians and clinicians serving mostly middle-income patients. Providers without teaching hospital privileges had lower odds of referral.
CONCLUSIONS
Adherence to clinical recommendations is essential to curbing the childhood obesity epidemic. Only one in four surveyed clinicians were aware of weight management programs in their community meeting U.S. Preventive Services Task Force criteria. Half of clinicians referred pediatric patients with obesity to a weight management program. Results suggest efforts are needed to increase awareness of, and referral to, weight management programs meeting the recommendation.
简介
美国预防服务工作组建议临床医生对 6 岁或以上的儿童进行肥胖筛查，并为肥胖儿童提供或转介他们参加强化体重管理计划。本研究探讨了临床医生对符合建议的体重管理计划的知晓情况、筛查和转介建议的遵循情况，以及提供者和实践特征与体重管理计划转介之间的关联。
方法
本横断面研究使用了 2017 年 DocStyles 调查的资料，这是一项基于网络的小组调查，于 2017 年进行了分析。在 1023 名看儿科患者的临床医生中，本研究调查了他们对所在社区符合建议的体重管理计划的知晓情况、对儿童肥胖症的筛查情况以及向体重管理计划的转介情况。多变量逻辑回归估计了临床医生的人口统计学和实践特征与体重管理计划转介之间的关联。
结果
只有 24.6%的被调查临床医生了解他们所在社区符合美国预防服务工作组建议的体重管理计划；在了解这些计划的人中，88.9%将患者转介到这些体重管理计划。大多数（83.6%）临床医生在≥75%的就诊中对儿童进行肥胖筛查。总体而言，53.5%的临床医生向体重管理计划转介。女性临床医生和主要为中等收入患者服务的临床医生的转介率更高。没有教学医院特权的提供者转介的可能性较低。
结论
遵守临床建议对于遏制儿童肥胖症的流行至关重要。在接受调查的临床医生中，只有四分之一的人了解他们所在社区符合美国预防服务工作组标准的体重管理计划。一半的临床医生将肥胖的儿科患者转介到体重管理计划。结果表明，需要努力提高对符合建议的体重管理计划的认识和转介。
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