title: Applying practice recommendations for the prevention and treatment of obesity in children and adolescents.
abstract: To describe pediatric clinicians' adherence to practice recommendations for obesity prevention and treatment, we conducted a cross-sectional analysis of 227 medical records of 3- to 18-year-old patients (seen from September 2003 to April 2004) and a longitudinal analysis of data from 632 overweight and obese patients (followed through March 2006). The cross-sectional analysis showed that early practice adopters (n = 3) more frequently recorded BMI (91% of patients), a diagnosis (89%), and counseling (82%) compared with late adopters (n = 9; 34%, 51%, and 48% of patients, respectively; P < .001). The longitudinal analysis showed that among overweight and obese patients, documentation of BMI dropped from 96% at the first clinic visit to 27% by the fifth visit; documentation of individual risk behaviors fell from >or=72% at the first visit to <or=23% at the fifth visit. Despite initial adoption of screening and assessment practices, clinicians' attention to weight management diminished over time.
authors.affiliation: Yale University School of Medicine, New Haven, CT 06520-8064, USA. Karen.Dorsey@yale.edu
authors.forename: Karen B
authors.initials: KB
authors.lastname: Dorsey
authors.forename: Maria
authors.initials: M
authors.lastname: Mauldon
authors.forename: Ruth
authors.initials: R
authors.lastname: Magraw
authors.forename: Julie
authors.initials: J
authors.lastname: Valka
authors.forename: Sunkyung
authors.initials: S
authors.lastname: Yu
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D037001:Directive Counseling; D019983:Guideline Adherence; D006801:Humans; D008137:Longitudinal Studies; D009765:Obesity / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D015431:Weight Loss