Health Care Providers' Perceived Role in Changing Environments to Promote Healthy Eating and Physical Activity: Baseline Findings From Health Care Providers Participating in the Healthy Eating, Active Communities Program

Samuels & Associates, Oakland, California, USA.
PEDIATRICS (Impact Factor: 5.47). 07/2009; 123 Suppl 5(Supplement 5):S293-300. DOI: 10.1542/peds.2008-2780H
Source: PubMed
The California Endowment's Healthy Eating, Active Communities program was designed to reduce disparities in the incidence of obesity by improving food and physical-activity environments for low-income children. It was recognized at the outset that to succeed, the program needed support from community advocates. Health care providers can be effective advocates to mobilize community members and influence policy makers.
This study was conducted to describe how health care providers address obesity prevention in clinical practice and to assess health care providers' level of readiness to advocate for policies to prevent childhood obesity.
The study included two data-collection methods, (1) a self-administered survey of health care providers (physicians, dietitians, nurses, nurse practitioners, medical assistants, and community health workers) and (2) stakeholder interviews with health care facility administrators, health department staff, and health insurance organization representatives. Two-hundred and forty-eight health care providers participated in the provider survey and the health care stakeholder interviews were conducted with 56 respondents.
The majority (65%) of health care providers usually or always discussed the importance of physical-activity, reducing soda consumption, and breastfeeding (as appropriate) during clinical pediatric visits. More than 90% of the providers perceived home or neighborhood environments and parental resistance as barriers to their efforts to prevent childhood obesity in clinical practice. More than 75% of providers reported not having engaged in any policy/advocacy activities related to obesity-prevention. Most (88%) of the stakeholders surveyed thought that health care professionals should advocate for policies to reduce obesity, especially around insurance coverage for obesity-prevention.
Providers perceived that changing the food and physical-activity environments in neighborhoods and schools was likely to be the most effective way to support their clinical obesity-prevention efforts. Health care providers need time, training, resources, and institutional support to improve their ability to communicate obesity-prevention messages in both clinical practice and as community policy advocates.

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    • "This is similar to what Boyle, Lawrence, Schwarte, Samuels, and McCarthy (2009) found in a survey to 248 health care providers serving low-income communities in California. When the health care providers (including physicians, dietitians, nurses, nurse practitioners, medical assistants, and community health care workers) rated various barriers to obesity prevention efforts, the top two barriers came out to be " parental resistance " (91%) and " family or neighborhood environments undermine recommendations " (90%) (Boyle et al., 2009). Also, in the study by Holt et al. (2011) of primary care physicians located in Southern Appalachia, providers rated the top two barriers to obesity treatment to be lack of parent involvement (32.4% most of the time) and lack of patient motivation (21.6% most of the time). "
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