Abstract
Childhood obesity is a serious health concern, especially in rural areas. Its management involves in-depth lifestyle and psychosocial assessment as well as patient-centered counseling. Telemedicine has increased the ability of patients in rural areas to obtain subspecialty consultations. Our objective was to determine whether a significant difference in quality of care, as measured by parent satisfaction, existed between consultations for childhood obesity delivered face to face and by telemedicine. We performed a pilot study in which questionnaires were distributed to parents of children under 12 years of age who had received consultations for childhood obesity at a university-affiliated pediatric weight management clinic, either face to face or by telemedicine. The questionnaires assessed various aspects of quality of care and patient-centered care including consulting providers' listening skills, ease of understanding instructions delivered to patients and their families, and the comfort level of parents in discussing health concerns. A total of 54 surveys were collected (22 telemedicine, 32 face-to-face). Of those, 25 (10 telemedicine, 15 face-to-face) met inclusion criteria. There was no difference in overall parent satisfaction with consultations between the two groups. However, parents rated telemedicine visits slightly lower than face-to-face visits when asked whether the provider explained things about the child's health in a way that was easy to understand (p=0.01). All parents of children who had received care via telemedicine said that they would participate in telemedicine consultations again. In our pilot, there was no significant difference in parent satisfaction between consultations for childhood obesity delivered face to face and by telemedicine. Therefore, preliminary evidence suggests that childhood obesity care delivered by telemedicine can improve access to quality patient-centered care in underserved rural areas. An important limitation is our sample size, which was not large enough to determine whether satisfaction in the telemedicine group was greater than in the face-to-face group.
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