title: Pediatric obesity management: variation by specialty and awareness of guidelines.
abstract: A survey of 2727 pediatric clinicians evaluated pediatric overweight management and awareness of Expert Committee recommendations (ECR) on obesity. Adjusted response rate was 45%. ECR awareness was reported by 24.6%. Family practice specialists (FPS) were less likely than pediatric specialists (PS) to be aware of ECR (OR, 0.46; 95% CI, 0.30-0.71). Body mass index (BMI) was never used by 25.6% to identify overweight; 35.4% did not obtain laboratory tests. Among PS but not FPS, ECR awareness was associated with BMI use (OR, 2.70; 95% CI, 1.56-4.65) and frequent follow-up (OR, 2.48; 95% CI, 1.58-3.90). FPS were more likely than PS to use BMI (OR, 1.78; 95% CI, 1.15-2.75) and obtain thyroid function tests (OR, 2.58; 95% CI, 1.53-4.37), but less likely to obtain fasting lipids (OR, 0.47; 95% CI, 0.30-0.73). Specialty differences in dietary recommendations, referrals, and barriers to treatment were identified. Pediatric overweight management guidelines should consider specialty differences and be accessible to all pediatric care providers.
authors.affiliation: Division of Endocrinology, Children's Hospital Boston, Boston, Massachusetts 02115, USA. erinn.rhodes@childrens.harvard.edu
authors.forename: Erinn T
authors.initials: ET
authors.lastname: Rhodes
authors.forename: Cara B
authors.initials: CB
authors.lastname: Ebbeling
authors.forename: Alan F
authors.initials: AF
authors.lastname: Meyers
authors.forename: Cynthia T
authors.initials: CT
authors.lastname: Bayerl
authors.forename: Wee L
authors.initials: WL
authors.lastname: Ooi
authors.forename: Maria F
authors.initials: MF
authors.lastname: Bettencourt
authors.forename: David S
authors.initials: DS
authors.lastname: Ludwig
mesh_terms: D015992:Body Mass Index; D005194:Family Practice; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D009722:Nurse Practitioners; D050177:Overweight; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D011320:Primary Health Care