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Screening and managing obesity: understanding paediatric residents’ knowledge, attitudes and practice
  1. Vickie Wu1,
  2. Carolyn Rosen1,
  3. Stephanie Pan2,
  4. Leora Mogilner1
  1. 1Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  1. Correspondence to Dr Vickie Wu, Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA; vickie.wu{at}mountsinai.org

Abstract

Study purpose Prior studies have identified paediatric attending physicians’ screening and management patterns related to overweight/obesity, but less is known about resident physicians’ behaviour. The objective was to understand paediatric resident physicians’ knowledge, attitude and practice patterns of overweight/obesity screening and management.

Study design We performed a retrospective chart review of preventive visits conducted by residents between August and October 2019. Charts of patients 2–18 years with body mass index ≥85th percentile at the visit were reviewed (85th–<95th for age and sex defined as overweight, ≥95th defined as obese). A survey was distributed to residents assessing knowledge, attitudes and barriers towards obesity management.

Results Of 1250 visits reviewed, 405 (32%) patients met the criteria for overweight or obesity. 39% were identified correctly by the provider, 53% were not identified and 8% were identified incorrectly. 89% of patients had diet history, 31% had physical activity and 43% had family history documented. Patients with obesity received physical activity documentation/counselling, portion size counselling, at least one referral, laboratory tests and a diagnosis more often than overweight patients. 84% of residents completed the survey. Although the majority of residents felt ‘somewhat’ or ‘very’ well prepared to counsel families about overweight/obesity, the majority thought their counselling on overweight/obesity was ‘not at all’ or ‘slightly’ effective.

Conclusion Despite residents feeling prepared and comfortable discussing overweight/obesity with patients, these diagnoses were often under-recognised or incorrectly made and appropriate counselling was lacking. Future work will focus on specific strategies to improve diagnosis, screening and management of overweight/obesity and include educational interventions and electronic medical record adaptations.

  • paediatrics
  • medical education & training

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Footnotes

  • Contributors VW, CR and LM conceived of the study and participated in its design. VW acquired the data. VW, SP and LM made substantial contributions to the analysis and interpretation of data. All authors were involved in drafting the manuscript and critically reviewing and revising it. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was deemed exempt by the Icahn School of Medicine Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The data sets generated and analysed during the study are available from the corresponding author (VW) on reasonable request.

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