Perceived challenges to implementing childhood obesity prevention strategies in pediatric primary care

Abstract

Childhood is an opportune time to address issues related to weight management, as children with obesity are more likely to have obesity in adulthood, and few successful long-term weight loss strategies exist. In 2007, an Expert Committee established guidelines for integrating obesity prevention into primary care, yet few studies have examined the extent to which pediatric primary care providers provide education about nutrition and physical activity at preventive (i.e., well-child) visits. This study aimed to identify challenges encountered and strategies used by pediatric primary care providers in South Carolina to address childhood obesity. Two focus group discussions (FGDs) were conducted with pediatric primary care providers (n ​= ​23) from a federally qualified health center (FQHC) in South Carolina. Participants responded to a series of semi-structured, open-ended questions about their experiences integrating obesity prevention and treatment into primary care. Focus groups were audio recorded and transcribed verbatim. Two coders used an iterative coding and consensus-building process to identify themes and subthemes, finalize coding, and extract illustrative quotations. Providers reported that families they served experienced many barriers to healthy eating and physical activity, including lack of community-based programming and social determinants of health. Provider-focused challenges were also identified, including time constraints, lack of focus on prevention, and logistic issues. . Providers described multiple strategies to address childhood obesity in their pediatric practice, including using family-centered approaches and tailoring obesity prevention and treatment approaches to patient demographics (e.g., age, ethnicity, comorbid conditions). A number of tools were also described as helpful in promoting physical activity and healthy eating during well-child visits.