title: Children's report of lifestyle counseling differs by BMI status.
abstract: BACKGROUND
  This study examined whether children's report of receiving weight, nutrition, and physical activity counseling from their clinicians differs by their BMI status and identified factors associated with higher rates of counseling.
  
  
  METHODS
  Physical assessments and health surveys were collected from a school-based sample of 959 5(th) and 6(th) grade students. Multivariate logistic regression analysis was used to examine how lifestyle counseling differs by BMI status, adjusting for race, gender, socioeconomic status, co-morbidities, site of care provider, and age.
  
  
  RESULTS
  Healthy weight children reported receiving the least amount of lifestyle counseling, with nearly one-quarter reporting none at all. Overweight children were no more likely than their healthy weight peers to report receiving weight and nutrition counseling. As expected, obese children were approximately two times more likely to report being counseled on their weight, nutrition, or physical activity as compared to healthy weight children (all p values at least <0.01). However, 23.9% of obese children reported receiving no counseling about their weight. After adjusting for BMI and all other confounding factors, for each lifestyle topic, Hispanics were at least 1.84 times more likely than whites to report being counseled (all p values at least <0.05). Blacks were at least 1.38 times more likely than whites to report being counseled (all p values at least <0.05). Girls were at least 1.38 times more likely than boys to report being counseled (all p values at least <0.05).
  
  
  CONCLUSIONS
  Although lifestyle counseling is universally recommended, many children report not receiving counseling. Despite clinical indications for more intensive counseling, overweight children report similar counseling rates as their healthy weight peers. Furthermore, a substantial proportion of obese children report not receiving lifestyle counseling. Future research should examine how lifestyle counseling can more effectively reach all children.
authors: Yale University School of Medicine, New Haven, CT 06511, USA. Stacey.Kallem@yale.edu
authors: Stacey
authors: S
authors: Kallem
authors: Amy
authors: A
authors: Carroll-Scott
authors: Kathryn
authors: K
authors: Gilstad-Hayden
authors: Susan M
authors: SM
authors: Peters
authors: Catherine
authors: C
authors: McCaslin
authors: Jeannette R
authors: JR
authors: Ickovics
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D037001:Directive Counseling / Q000592:standards*; D015444:Exercise; D005260:Female; D006266:Health Education / Q000592:standards*; D006306:Health Surveys; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015995:Prevalence; D040242:Risk Reduction Behavior; D012572:School Health Services / Q000592:standards*; D057566:Self Report; D012923:Social Class; D013334:Students; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
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