Departments of Pediatrics and Family & Community Medicine, Pediatric Multidisciplinary Weight Loss Program, Penn State Hershey Medical Center, Hershey, PA, USA.
Penn State College of Medicine, Hershey, PA, USA.
Transl Behav Med. 2019 May 16;9(3):460-467. doi: 10.1093/tbm/ibz030.
Pediatric obesity remains disproportionately more prevalent in rural communities; however, multidisciplinary, pediatric weight loss programs, which are often located in tertiary-care centers, may not be accessible to rural families. Limited models to specifically address pediatric obesity in rural communities exist. Therefore, innovative solutions are required for expanded treatment of pediatric obesity in rural communities. This article discusses potential solutions for multidisciplinary, tertiary-care pediatric weight loss programs to improve access and treatment of pediatric obesity in rural communities. A selected review of the literature suggests that strategies to overcome barriers to treatment in rural communities include telephone calls and telemedicine conferencing by obesity specialists from academic centers (obesity medicine specialists, endocrinologists, dietitians, and psychotherapists) as well as training local primary care providers in rural communities to screen, diagnose, and treat patients with obesity. Multidisciplinary, tertiary-care pediatric weight loss programs have a profound opportunity to impact the treatment of pediatric obesity in rural communities by training practicing rural primary care providers as well as strengthening their commitment to educate future generations of clinicians on the treatment of pediatric obesity through medical training including physician assistant, nurse practitioner, and pediatric and family medicine resident education and skill building. This article identifies potential mechanisms for expansive treatment of pediatric obesity in rural communities by multidisciplinary, tertiary-care weight loss programs and highlights areas of specific focus needed for future investigation.
儿科肥胖在农村社区仍然更为普遍；然而，多学科的儿科减肥项目通常位于三级保健中心，可能无法为农村家庭所接受。目前存在针对农村社区儿童肥胖问题的有限模式。因此，需要创新的解决方案来扩大农村社区儿童肥胖的治疗。本文讨论了多学科三级保健儿科减肥项目的潜在解决方案，以改善农村社区儿童肥胖的治疗机会。对文献的选择性回顾表明，克服农村社区治疗障碍的策略包括：由学术中心的肥胖专家（肥胖医学专家、内分泌学家、营养师和心理治疗师）进行电话和远程医疗会议，以及培训农村社区的当地初级保健提供者进行筛查、诊断和治疗肥胖患者。多学科三级保健儿科减肥项目有机会通过培训农村初级保健提供者，以及通过医疗培训（包括医师助理、执业护士、儿科和家庭医学住院医师教育和技能培养）加强他们对教育未来几代临床医生治疗儿童肥胖的承诺，从而对农村社区的儿童肥胖治疗产生深远影响。本文确定了多学科三级保健减肥项目在农村社区广泛治疗儿童肥胖的潜在机制，并强调了未来调查需要关注的具体领域。
