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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    • "There is limited knowledge on the practical experience involved with planning and implementation of community-based obesity prevention programmes (King et al., 2011). Recent studies have covered Australia (Wilson et al., 2009, de Groot et al., 2010, de Silva-Sanigorki et al., 2010) and America (Boyle et al., 2009, Po " e et al., 2010, Dreisinger, et al., 2011), however little has been published documenting efforts in the UK. The findings from this investigation, illustrate the challenging experiences of stakeholders when implementing a large community-based obesity prevention programme in the north-east of England. "
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    • "Some of these barriers include lack of knowledge and behaviour management (Gance-Cleveland et al., 2009; Steele et al., 2011). Difficulties in raising weight issues, such as stigma and personal fears, also limit their ability to promote healthier habits (Boyle et al., 2009; Klein et al., 2010; Steele et al., 2011). Thus, different management guidelines, practice recommendations Health Promotion International doi:10.1093/heapro/dat023 "
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    • "This might seem a natural role for physicians, extending their health promotion efforts with their patients to the community. Unfortunately, although many health care providers are aware of the childhood obesity epidemic, are concerned about its health impacts, and want to work on its prevention, they continue to see themselves primarily as clinical practitioners and not as health educators or advocates in the broader community [73]. "
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