Referrals for pediatric weight management: the importance of proximity.
BACKGROUND
Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity.


METHODS
All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009.


RESULTS
Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children.


CONCLUSIONS
Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.
Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Kathryn A
KA
Ambler
Douglas W J
DW
Hagedorn
Geoff D C
GD
Ball
D000046:Academic Medical Centers; D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D000416:Alberta; D000886:Anthropometry; D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D015331:Cohort Studies; D004038:Diet, Reducing; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000706:statistics & numerical data; D010372:Pediatrics; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult