title: Screening and counseling for childhood obesity: results from a national survey.
abstract: OBJECTIVE
  To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity.
  
  
  METHODS
  Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006.
  
  
  RESULTS
  729 surveys were returned; 445 were eligible. Most (71%) members were familiar with BMI guidelines; 41% were familiar with American Academy of Family Physician recommendations about overweight. Most (78%) had tools available to calculate BMI; fewer have enough time for overweight screening (55%), and only 45% reported computing BMI percentile at most or every well visit for children older than 2. Having an electronic health record increased BMI screening rates. Family physicians felt prepared to discuss weight, but only 43% believed their counseling was effective and many (55%) lack community or referral services. Most (72%) wanted simple diet and exercise recommendations for patients. Reimbursement for weight-related services is insufficient: 86% say that patients cannot pay for services not covered by insurance. Factor analysis identified clinician self-efficacy, resources, and reimbursement as factors related to calculating BMI percentiles.
  
  
  CONCLUSIONS
  BMI is underutilized by family physicians. Most believe they should try to prevent overweight and have tools to use BMI, but clinicians have few resources available for treatment, have low self-efficacy, and report inadequate reimbursement.
authors.affiliation: Division of Adolescent Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: Tracy S
authors.initials: TS
authors.lastname: Sesselberg
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Klein
authors.forename: Karen G
authors.initials: KG
authors.lastname: O'Connor
authors.forename: Mark S
authors.initials: MS
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015992:Body Mass Index; D002648:Child; D002669:Child Welfare; D037001:Directive Counseling; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007087:Illinois; D008297:Male; D008403:Mass Screening; D009749:Nutrition Surveys; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D010465:Perception; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'