Youths' perceptions of overweight-related prevention counseling at a primary care visit.
OBJECTIVE
We examined youths' report of receiving specific overweight-related preventive counseling and perceived readiness to adopt nutrition and physical activity behaviors recommended by their clinicians.


METHODS
We surveyed 324 youth 10 to 18 years old who had a physical exam within the past year. The survey included questions on height, weight, race/ethnicity, mother's education, and topics they discussed with their clinician during their visit. We used multivariable analyses to examine whether weight status and sociodemographic characteristics were predictors of which youth received counseling from their clinicians and which youth were ready to change.


RESULTS
The mean (standard deviation) age of participants was 13.7 (1.8) years; 54% were black, and 22% were Hispanic. Less than one-half of participants reported discussing sugar-sweetened beverages [38%; 95% confidence interval (CI), 32% to 43%] or television viewing (41%; 95% CI, 36% to 47%) with their clinicians. In multivariable analyses adjusting for participant's age, sex, race/ethnicity, overweight status, and mother's educational attainment, youth whose mothers lacked education beyond high school were significantly less likely to report receiving counseling on any overweight-specific topic including television viewing [odds ratio (OR), 0.46; 95% CI, 0.27, 0.79], sugar-sweetened beverage (OR, 0.47; 95% CI, 0.28, 0.80), and fast food consumption (OR, 0.54; 95% CI, 0.32, 0.92). In addition, youth 10 to 14 years old were more likely than those 15 to 18 years old to report they would try to change their television viewing (OR, 4.10; 95% CI, 1.78, 9.44) if recommended by their clinician.


CONCLUSIONS
Youth report infrequently receiving counseling on specific overweight prevention topics during routine primary care visits. Our findings suggest that greater efforts may be needed to reduce social class disparities in overweight prevention counseling and that counseling to prevent overweight in youth may be more acceptable to younger children.
Taveras
Elsie M
EM
Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Sixth Floor, Boston, MA 02215, USA. Elsie_Taveras@hphc.org
Sobol
Arthur M
AM
Hannon
Cynthia
C
Finkelstein
Daniel
D
Wiecha
Jean
J
Gortmaker
Steven L
SL
D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D037001:Directive Counseling / Q000379:methods; D015444:Exercise; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D009819:Office Visits; D050177:Overweight; D010372:Pediatrics / Q000379:methods*; D010465:Perception; D011320:Primary Health Care / Q000379:methods*