Childhood obesity: how do Australian general practitioners feel about managing this growing health problem?
Erin McMeniman A , Romayne Moore B E , Michael Yelland C and Rod McClure DA Dermatology Registrar, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Qld 4102, Australia.
B Academic General Practice Registrar, Primary Health Care, School of Medicine, Logan Campus, Griffith University, University Drive, Meadowbrook, Qld 4131, Australia.
C Primary Health Care, School of Medicine, Logan Campus, Griffith University, University Drive, Meadowbrook, Qld 4131, Australia.
D Accident Research Centre, Building 70, Monash University, Melbourne, Vic., 3800, Australia.
E Corresponding author. Email: r.moore@griffith.edu.au
Australian Journal of Primary Health 17(1) 60-65 https://doi.org/10.1071/PY10041
Submitted: 10 August 2010 Accepted: 17 November 2010 Published: 16 March 2011
Abstract
General practitioners (GPs) are ideally placed to identify and treat childhood obesity, but its prevalence continues to rise and evidence for effective GP interventions is lacking. Further analysis of the barriers to effective identification and management of childhood obesity is warranted. This survey aimed to explore how Queensland GPs feel about managing the growing problem of childhood obesity. A cross-sectional survey was sent to a random sample of 573 Queensland GPs about perceptions of diagnosis and management of childhood obesity. A total of 30% of GPs responded (n = 170). The main perceived obstacles to identification of childhood obesity were uncertainty about definition criteria and how to calculate body mass index, and lack of access to body mass index percentile charts. The main perceived obstacles in managing childhood obesity were lack of financial incentive, time constraints, lack of health system support and parental resistance. Only 22% of respondents indicated awareness of the National Health and Medical Research Council guidelines for management of obese children and 92% had never used any formal clinical guidelines in assessment or management of childhood obesity. Addressing these barriers to identification of childhood obesity by GPs may facilitate more effective management. Strategies include greater emphasis on this issue in general practice training, financial incentives for diagnosis and management, incorporating clinical management guidelines into medical software, and increasing allied and community health support.
Additional keywords: child, perception.
References
Australian Bureau of Statistics (2009) National Health Survey: summary of results, 2007–2008. ABS cat. no. 4364.0. ABS, Canberra. Available at http://www.aihw.gov.au/publications/aus/ah10/ah10.pdf [Verified 14 September 2010]Batch J, Baur L (2005) Management and prevention of obesity and its complications in children and adolescents. The Medical Journal of Australia 182, 130–135.
Britt H, Miller G, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, Fahridin S, O’Halloran J (2009) ‘General practice activity in Australia, 2008–2009.’ (AIHW: Canberra)
Buffart L, van der Ploeg H, Smith B, Kurko J, King L, Bauman AE (2009) General practitioners’ perceptions and practices of physical activity counselling: changes over the past 10 years. British Journal of Sports Medicine 43, 1149–1153.
| General practitioners’ perceptions and practices of physical activity counselling: changes over the past 10 years.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MjpsF2ktg%3D%3D&md5=6307d89fc6db3c4038fcebe540f84c1fCAS | 18628359PubMed |
Campbell K, Engel H, Timperio A, Cooper C, Crawford D (2000) Obesity management: Australian general practitioners attitudes and practices. Obesity Research 8, 459–466.
| Obesity management: Australian general practitioners attitudes and practices.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvltlKlsA%3D%3D&md5=0734d7e00e2d19083adee64bc8b6e802CAS | 11011913PubMed |
Centers for Disease Control and Prevention (2000) ‘Clinical growth charts.’ (CDC: Atlanta) Available at http://www.cdc.gov/growthcharts/clinical_charts.htm [Verified 4 June 2006]
Chamberlin L, Sherman S, Jain A, Powers S, Whitaker R (2002) The challenge of preventing and treating obesity in low income preschool children. Archives of Pediatrics & Adolescent Medicine 156, 662–668.
Dettori H, Elliott H, Horn J, Leong G (2009) Barriers to the management of obesity in children: a cross sectional survey of GPs. Australian Family Physician 38, 460–464.
Gerner B, McCallum Z, Sheehan J, Harris C, Wake M (2006) Are general practitioners equipped to detect child overweight/obesity? Journal of Paediatrics and Child Health 42, 206–211.
| Are general practitioners equipped to detect child overweight/obesity?Crossref | GoogleScholarGoogle Scholar |
Gillis D, Brauner M, Granot E (2007) A community-based behavior modification intervention for childhood obesity. Journal of Pediatric Endocrinology & Metabolism 20, 197–203.
Guo S, Chumlea W (1999) Tracking of body mass index in children in relation to overweight in adulthood. The American Journal of Clinical Nutrition 70, 145S–148S.
Hearn L, Miller M, Cross D (2007) Engaging primary health care providers in the promotion of healthy weight among young children: Barriers and enablers for policy and management. Australian Journal of Primary Health 13, 66–79.
| Engaging primary health care providers in the promotion of healthy weight among young children: Barriers and enablers for policy and management.Crossref | GoogleScholarGoogle Scholar |
Hughes A, Stewart L, Chapple J, McColl JH, Donaldson MDC, Kelner CJH, Zabihollah M, Ahmed F, Reilly JJ (2008) Randomized, controlled trial of a best-practice individualized behavioral program for treatment of childhood overweight: Scottish Childhood Overweight Treatment Trial (SCOTT). Pediatrics 121, e539–e546.
| Randomized, controlled trial of a best-practice individualized behavioral program for treatment of childhood overweight: Scottish Childhood Overweight Treatment Trial (SCOTT).Crossref | GoogleScholarGoogle Scholar |
Lau D (2006) A pilot study on the attitudes and practice relating to the management of overweight and obese patients among primary health care professionals in four primary care clinics in Hong Kong. The Hong Kong Practitioner 28, 155–165.
McCallum Z, Wake M, Gerner B, Baur LA, Gibbons K, Gold L, Gunn J, Harris C, Naughton G, Riess C, Sanci L, Sheehan J, Ukoumunne OC, Waters E (2007) Outcome Data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. International Journal of Obesity 31, 630–636.
National Health and Medical Research Council (2003) ‘Clinical practice guidelines for the management of overweight and obesity in children and adolescents.’ (NHMRC: Canberra)
National Preventative Health Taskforce (2009) Technical paper 1: Obesity in Australia: a need for urgent action. Available at http://www.health.gov.au/internet/preventativehealth/publishing.nsf/Content/tech-obesity-toc [Verified 15 July 2010]
O’Brien P, Brown W, Dixon J (2005) Obesity, weight loss and bariatric surgery. The Medical Journal of Australia 183, 310–314.
Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O’Malley C, Stolk RP, Summerbell CD (2009) Interventions for treating obesity in children. Cochrane Database of Systematic Reviews (Online) 1, CD001872
Patrick K, Calfas KJ, Norman GJ, Zabinski MF, Sallis JF, Rupp J, Covin J, Cella J (2006) Randomized controlled trial of a primary care and home-based intervention for physical activity and nutrition behaviors: PACE+ for adolescents. Archives of Pediatrics & Adolescent Medicine 160, 128–136.
| Randomized controlled trial of a primary care and home-based intervention for physical activity and nutrition behaviors: PACE+ for adolescents.Crossref | GoogleScholarGoogle Scholar | 16461867PubMed |
Spivack J, Swietlik M, Alessandrini E, Faith M (2010) Primary care providers’ knowledge, practices, and perceived barriers to the treatment and prevention of childhood obesity. Obesity 18, 1341–1347.
| Primary care providers’ knowledge, practices, and perceived barriers to the treatment and prevention of childhood obesity.Crossref | GoogleScholarGoogle Scholar | 19910934PubMed |
van Gerwen M, Franc C, Rosman S, Le Vaillant M, Pelletier-Fleury N (2009) Primary care physicians’ knowledge, attitudes, beliefs and practices regarding childhood obesity: a systematic review. Obesity Reviews 10, 227–236.
Wake M, Baur L, Gerner B, Gibbons K, Gold L, Gunn J, Levickis P, McCallum Z, Naughton G, Sanci L, Ukoumunne OC (2008) Outcomes and costs of primary care surveillance and intervention for overweight or obese children: the LEAP 2 randomised controlled trial. British Medical Journal 339, b3308
World Health Organization (2003) ‘Nutrition: controlling the global obesity epidemic.’ Available at http://www.who.int/nutrition/topics/obesity/en/ [Verified 14 May 2006]
