title: Pediatricians' and family physicians' weight-related care of children in the U.S.
abstract: BACKGROUND
  Few national data exist to assess primary care physicians' (PCPs') clinical practices with regard to childhood obesity.
  
  
  OBJECTIVE
  To survey pediatricians and family practice physicians regarding their assessment, counseling, and management of diet, physical activity, and weight status among pediatric patients in the primary care setting.
  
  
  METHODS
  A nationally representative cross-sectional survey of pediatricians and family practice physicians sampled from the American Medical Association (AMA) Masterfile was conducted in 2008 and analyzed in 2010. Outcomes included physicians' self-reported practice behaviors regarding assessments of pediatric patients' weight status, counseling of diet and physical activity, and referrals and follow-ups.
  
  
  RESULTS
  Response rate excluding physicians listed as "no-contact" by the AMA was 73.7% among pediatricians and 66.9% among family physicians. Less than 50% of all PCPs assessed BMI percentiles regularly in children. Eighteen percent of all PCPs reported referring children for further evaluation or management. Fifty-eight percent of all PCPs reported never, rarely, or only sometimes tracking patients over time concerning weight or weight-related behaviors. Pediatricians were more likely than family physicians to assess weight status and provide behavioral counseling (p's<0.001).
  
  
  CONCLUSIONS
  Active PCP participation in assessing or managing childhood obesity in the primary care setting appears low relative to the frequency of the problem in the U.S. Interventions to reduce the barriers to physician engagement in the assessment and management of healthy lifestyles are needed to prevent and control childhood obesity.
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA.
authors.forename: Terry T-K
authors.initials: TT
authors.lastname: Huang
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Borowski
authors.forename: Benmei
authors.initials: B
authors.lastname: Liu
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Galuska
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
authors.forename: Susan Z
authors.initials: SZ
authors.lastname: Yanovski
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Olster
authors.forename: Audie A
authors.initials: AA
authors.lastname: Atienza
authors.forename: Ashley Wilder
authors.initials: AW
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D005194:Family Practice / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control* / Q000628:therapy; D010372:Pediatrics / Q000379:methods; D010821:Physicians, Family / Q000458:organization & administration; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D014481:United States