Ambulatory Pediatrics
Volume 5, Issue 3 , Pages 150-156 , May 2005

Preventing and Treating Obesity: Pediatricians' Self-Efficacy, Barriers, Resources, and Advocacy

  • Eliana Miller Perrin, MD, MPH

      Affiliations

    • Corresponding Author InformationAddress correspondence to Eliana Miller Perrin, MD, MPH, Assistant Professor, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, CB No. 7220, 130 Mason Farm Road, 5th Floor Bioinformatics Building, Chapel Hill, NC, 27599-7220
    • ,
  • Kori B. Flower, MD, MS, MPH

      Affiliations

    • From the Division of General Pediatrics and Adolescent Medicine (Drs Perrin and Flower), Department of Pediatrics; the Robert Wood Johnson Clinical Scholars Program (Drs Flower and Garrett); the Division of General Internal Medicine (Dr Garrett), Department of Medicine; and the Department of Nutrition and Center for Health Promotion and Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Schools of Medicine and Public Health, Chapel Hill, NC
    • ,
  • Joanne Garrett, PhD

      Affiliations

    • From the Division of General Pediatrics and Adolescent Medicine (Drs Perrin and Flower), Department of Pediatrics; the Robert Wood Johnson Clinical Scholars Program (Drs Flower and Garrett); the Division of General Internal Medicine (Dr Garrett), Department of Medicine; and the Department of Nutrition and Center for Health Promotion and Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Schools of Medicine and Public Health, Chapel Hill, NC
    • ,
  • Alice S. Ammerman, DrPH, RD

      Affiliations

    • From the Division of General Pediatrics and Adolescent Medicine (Drs Perrin and Flower), Department of Pediatrics; the Robert Wood Johnson Clinical Scholars Program (Drs Flower and Garrett); the Division of General Internal Medicine (Dr Garrett), Department of Medicine; and the Department of Nutrition and Center for Health Promotion and Disease Prevention (Dr Ammerman), University of North Carolina at Chapel Hill, Schools of Medicine and Public Health, Chapel Hill, NC

Received 1 July 2004 ,Accepted 5 January 2005.

REFERENCES 

  1. Dietz WH . Health consequences of obesity in youth: childhood predictors of adult disease . Pediatrics . 1998;101:518–525
  2. Ogden CL , Flegal KM , Carroll MD , Johnson CL . Prevalence and trends in overweight among US children and adolescents, 1999–2000 . JAMA . 2002;288:1728–1732
  3. Bandura A . Social Foundations of Thought and Action: A Social Cognitive Theory . Upper Saddle River, NJ: Prentice-Hall; 1986;
  4. Cabana MD , Rand CS , Becher OJ , Rubin HR . Reasons for pediatrician non-adherence to asthma guidelines . Arch Pediatr Adolesc Med . 2001;155:1057–1062
  5. Eckstrom E , Hickam DH , Lessler DS , Buchner DM . Changing physician practice of physical activity counseling . J Gen Intern Med . 1999;14:376–378
  6. Lewis CE , Clancy C , Leake B , Schwartz JS . The counseling practices of internists . Ann Intern Med . 1991;114:54–58
  7. Thompson SC , Schwankovsky L , Pitts J . Counselling patients to make lifestyle changes: the role of physician self-efficacy, training and beliefs about causes . Fam Pract . 1993;10:70–75
  8. Cheng TL , DeWitt TG , Savageau JA , O'Connor KG . Determinants of counseling in primary care pediatric practice: physician attitudes about time, money, and health issues . Arch Pediatr Adolesc Med . 1999;153:629–635
  9. Ammerman AS , DeVellis BM , Haines PS , et al.   Nutrition education for cardiovascular disease prevention among low income populations—description and pilot evaluation of a physician-based model . Patient Educ Couns . 1992;19:5–18
  10. Price JH , Desmond SM , Ruppert ES , Stelzer CM . Pediatricians' perceptions and practices regarding childhood obesity . Am J Prev Med . 1989;5:95–103
  11. Kimm SY , Payne GH , Lakatos E , et al.   Management of cardiovascular disease risk factors in children. A national survey of primary care physicians . Am J Dis Child . 1990;144:967–972
  12. Nader PR , Taras HL , Sallis JF , Patterson TL . Adult heart disease prevention in childhood: a national survey of pediatricians' practices and attitudes . Pediatrics . 1987;79:843–850
  13. Story MT , Neumark-Stzainer DR , Sherwood NE , et al.   Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals . Pediatrics . 2002;110:210–214
  14. Kolagotla L , Adams W . Ambulatory management of childhood obesity . Obes Res . 2004;12:275–283
  15. Epstein LH , Valoski A , Wing RR , McCurley J . Ten-year outcomes of behavioral family-based treatment for childhood obesity . Health Psychol . 1994;13:373–383
  16. Cabana MD , Rand C , Slish K , et al.   Pediatrician self-efficacy for counseling parents of asthmatic children to quit smoking . Pediatrics . 2004;113:78–81
  17. Cabana MD , Ebel BE , Cooper-Patrick L , et al.   Barriers pediatricians face when using asthma practice guidelines . Arch Pediatr Adolesc Med . 2000;154:685–693
  18. Jelalian E , Boergers J , Alday CS , Frank R . Survey of physician attitudes and practices related to pediatric obesity . Clin Pediatr (Phila) . 2003;42:235–245
  19. Stettler N . Environmental factors in the etiology of obesity in adolescents . Ethn Dis . 2002;12:S1-41–S1-45
  20. Hill JO , Peters JC . Environmental contributions to the obesity epidemic . Science . 1998;280:1371–1374
  21. Perrin EM , Flower KB , Ammerman AS . Body mass index charts: useful yet underused . J Pediatr . 2004;144:455–460
  22. Kristeller JL , Hoerr RA . Physician attitudes toward managing obesity: differences among six specialty groups . Prev Med . 1997;26:542–549
  23. Price JH , Desmond SM , Krol RA , et al.   Family practice physicians' beliefs, attitudes, and practices regarding obesity . Am J Prev Med . 1987;3:339–345
  24. Langley GJ , Nolan KM , Nolan TW , et al.   The Improvement Guide: A Practical Approach to Enhancing Organizational Performance . San Francicso, Calif: Jossey-Bass Inc; 1996;
  25. Frankel L . The report of the CASRO task force on response rates . In: Wiseman F editors. Improving Data Quality in a Sample Survey . Cambridge, Mass: Marketing Science Institute; 1983;
  26. Tershakovec AM , Watson MH , Wenner WJ , Marx AL . Insurance reimbursement for the treatment of obesity in children . J Pediatr . 1999;134:573–578
  27. Barlow SE , Dietz WH . Obesity evaluation and treatment: Expert Committee recommendations The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services . Pediatrics . 1998;102:e29
  28. American Academy of Pediatrics, Committee on Nutrition. . Policy statement: prevention of pediatric overweight and obesity . Pediatrics . 2003;112:424–430
  29. American Academy of Pediatrics, Committee on School Health. . Policy statement: soft drinks in schools . Pediatrics . 2004;113:152–154
  30. Cummings SM , Savitz LA , Konrad TR . Reported response rates to mailed physician questionnaires . Health Serv Res . 2001;35:1347–1355
  31. Arscott-Mills T , DeLago C , Rhee K , et al.   Parental motivation and child obesity [abstract] . Pediatr Res . 2004;55:220A; Abstract 1243
  32. DeLago C , Arscott-Mills T , Rhee K , et al.   Communicating the obesity problem to the parents [abstract] . Pediatr Res . 2004;55:224A; Abstract 1268

 Presented in part at the Pediatric Academic Societies meetings, San Francisco, Calif, May 2004.

PII: S1530-1567(05)60194-3

doi: 10.1367/A04-104R.1

Ambulatory Pediatrics
Volume 5, Issue 3 , Pages 150-156 , May 2005

Article Tools

* Image Usage & Resolution