Carter Rebecca, Silber Molly, Weiss Lindsay, Sharaf Salma, Wang Yan, Hager Erin
University of Maryland, Baltimore, MD, USA.
Glob Pediatr Health. 2019 Apr 8;6:2333794X19840360. doi: 10.1177/2333794X19840360. eCollection 2019.
. To evaluate the impact of an obesity didactic session for pediatric physicians on confidence in counseling and identified overweight/obesity and follow-up recommendations. . Pediatric residents underwent training and completed pre/post online surveys evaluating confidence in obesity prevention and identification. A booster training occurred 1 year later. Pre-/post-training scores were compared using χ or Fisher's exact tests. Electronic medical records data for patients ≥3 years with BMI-for-age percentile ≥85 during 3 months prior/following the training/booster compared frequency of overweight/obesity identification and follow-up recommendations (≤3 months recommended vs longer) using logistic regression adjusting for age and overweight/obese status. . Post trainings, improvements in confidence to define/screen for obesity were observed, with a decline between trainings. Overweight/obese identification and follow-up time recommendations improved post-training (identification: 14.2% to 27.4%, adjusted odds ratio [aOR] = 3.16, 95% confidence interval [CI] = 1.54-6.51; follow-up: 48.9% to 58.9%, aOR = 1.63, 95% CI = 1.01-2.64), aOR = 1.77, 95% CI = 1.10-2.85, and identification remained stable/above pre-training rates both pre-/post-booster (25.8%, aOR = 3.14, 95% CI = 1.53-6.45; and 22.1%, aOR = 2.57, 95% CI = 1.25-5.30, respectively). Recommended follow-up time rates continued to rise when measured pre-booster (60.6%, aOR = 1.77, 95% CI = 1.10-2.85), then declined (46.0%, aOR = 0.95, 95% CI = 0.60-1.52). . This didactic session improved resident confidence in defining/screening, identification of overweight/obesity and follow-up recommendations; however, rates of identification remained low. The successes of this intervention support similar didactic sessions in residency programs and identifies opportunities for improved resident/attending education.
评估针对儿科医生的肥胖症教学课程对咨询信心、识别超重/肥胖情况及后续建议的影响。儿科住院医师接受培训并完成培训前后的在线调查，以评估其在肥胖预防和识别方面的信心。一年后进行强化培训。使用χ检验或费舍尔精确检验比较培训前后的得分。对培训/强化培训前后3个月内年龄≥3岁且年龄别BMI百分位数≥85的患者的电子病历数据，采用逻辑回归分析并调整年龄和超重/肥胖状态，比较超重/肥胖识别频率和后续建议（建议随访≤3个月与更长时间）。培训后，在定义/筛查肥胖症的信心方面有所改善，但两次培训之间有所下降。超重/肥胖识别和后续随访时间建议在培训后有所改善（识别：从14.2%提高到27.4%，调整后比值比[aOR]=3.16，95%置信区间[CI]=1.54 - 6.51；随访：从48.9%提高到58.9%，aOR = 1.63，95% CI = 1.01 - 2.64），aOR = 1.77，95% CI = 1.10 - 2.85，强化培训前后识别率均保持稳定/高于培训前水平（分别为25.8%，aOR = 3.14，95% CI = 1.53 - 6.45；和22.1%，aOR = 2.57，95% CI = 1.25 - 5.30）。在强化培训前测量时，建议的随访时间率持续上升（60.6%，aOR = 1.77，95% CI = 1.10 - 2.85），然后下降（46.0%，aOR = 0.95，95% CI = 0.60 - 1.52）。本次教学课程提高了住院医师在定义/筛查、识别超重/肥胖及后续建议方面的信心；然而，识别率仍然较低。该干预措施的成功支持了住院医师培训项目中类似的教学课程，并确定了改善住院医师/带教教师教育的机会。
