title: Prevention and treatment of childhood obesity: care received by a state medicaid population.
abstract: Based on chart review for a representative cluster sample of North Carolina Medicaid enrollees aged 3 to 5 years (n = 1951) and 13 to 16 years (n = 1922) years, this study describes prevalence, practice patterns, and comorbidities related to overweight/obese immediately prior to 2007 Expert Recommendations. In total, 16% of children in both age groups were overweight, and 20% (ages 3-5 years) and 25% (ages 13-16 years) were obese. For 3- to 5-year-olds, body mass index percentile was infrequently recorded (22%) or plotted on growth charts (24%), and weight status category was rarely documented (10%). Results were similar for adolescents (21%, 20%, and 12%, respectively). In both groups, documentation of counseling in nutrition or physical activity was rare (16% for ages 3-5 years; 7% for ages 13-16 years). In adolescents, approximately 20% received recommended laboratory screening and overweight/ obesity was significantly associated with chart-documented asthma, back pain, prediabetes, gastroesophageal reflux disease, hypertension, and sleep apnea. Whether improvements in documentation of care followed these new guidelines deserves further research.
authors.affiliation: Brody School of Medicine, East Carolina University, Greenville, NC, USA. lazoricks@ecu.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lazorick
authors.forename: Brandy
authors.initials: B
authors.lastname: Peaker
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Perrin
authors.forename: Dorothee
authors.initials: D
authors.lastname: Schmid
authors.forename: Tamerra
authors.initials: T
authors.lastname: Pennington
authors.forename: Angie
authors.initials: A
authors.lastname: Yow
authors.forename: C Annette
authors.initials: CA
authors.lastname: DuBard
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D015897:Comorbidity; D037001:Directive Counseling / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid; D008485:Medical Audit; D008499:Medical Records; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States