title: Training health care professionals to manage overweight adolescents: experience in rural Georgia communities.
abstract: BACKGROUND
  The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management.
  
  
  OBJECTIVE
  This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol. The study also documented the prevalence of obesity-associated physiological and behavioral risk factors among overweight adolescent patients.
  
  
  METHODS
  Ten rural clinics (58 providers) were recruited and received a 90-minute adolescent overweight assessment and management training session. Select biochemical, dietary, physical activity, and physical inactivity behaviors were assessed in overweight adolescent patients. Medical charts were abstracted to assess practitioner compliance with an overweight assessment protocol and patient adherence to a 16-week follow-up visit.
  
  
  RESULTS
  Providers were receptive to training and complied with the recommended protocol. Eighty-five overweight adolescents were assessed, but only 49 (57%) completed the scheduled 16-week follow-up visit. Physical, biochemical, and behavioral assessments revealed that 13%-27% of the participants had abnormal levels of lipids, fasting glucose, and glucose/insulin ratio, and 80.5% had waist circumferences above the 90th percentile.
  
  
  CONCLUSIONS
  Practitioners complied with the assessment and follow-up protocol, leading to the discovery of previously unrecognized risk factors in many overweight adolescent patients. Lack of patient adherence to follow-up was the greatest limiting factor for obesity management. Further efforts are needed to implement and evaluate training to improve the management of adolescent overweight, especially in rural communities.
authors.affiliation: ILSI Research Foundation, Washington, DC, USA. ddennison@cdc.gov
authors.forename: David A
authors.initials: DA
authors.lastname: Dennison
authors.forename: Zenong
authors.initials: Z
authors.lastname: Yin
authors.forename: Debra
authors.initials: D
authors.lastname: Kibbe
authors.forename: Susan
authors.initials: S
authors.lastname: Burns
authors.forename: Frederick
authors.initials: F
authors.lastname: Trowbridge
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001794:Blood Pressure; D005260:Female; D005845:Georgia; D015438:Health Behavior; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D050177:Overweight / Q000517:prevention & control*; D015397:Program Evaluation / Q000379:methods; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires