title: Understanding academic clinicians' varying attitudes toward the treatment of childhood obesity in Canada: a descriptive qualitative approach.
abstract: BACKGROUND
  This qualitative study aims to understand academic physicians' attitudes towards the treatment of pediatric obesity in Canada.
  
  
  METHODS
  A stratified sample of 24 participants (surgeons, pediatricians, family practitioners) were recruited from 4 Canadian regions. Semi-structured interviews were conducted and transcribed. A codebook was developed through iterative data reduction and conceptual saturation ensured. Validity was ensured through triangulation, audit trail, and member-checking.
  
  
  RESULTS
  This study revealed 45 themes with regional, specialty, and experiential differences. Quebec and Ontario emphasized education of physicians and parents to improve treatment and favored surgical intervention. Half of surgeons felt surgery was the only successful treatment option, while non-surgeons favored behavioral interventions. Experienced physicians in Western Canada desired more evidence to improve patient care, while inexperienced physicians focused on early detection and home environments. Across Canada participants advocated for program development and system change. Respondents expressed family involvement as integral to treatment success and shifting away from blame and moving towards a healthy lifestyles approach.
  
  
  CONCLUSIONS
  Canadian regional differences in physicians' attitudes towards pediatric obesity treatment exist, influenced by experience and specialty. We will understand how themes identified in this study influence real life clinical decision making by applying these results to create a discrete choice-based conjoint survey.
authors.affiliation: Department of Surgery, McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada L8N 3Z5. kbailey@mcmaster.ca
authors.forename: Karen
authors.initials: K
authors.lastname: Bailey
authors.forename: Julia
authors.initials: J
authors.lastname: Pemberton
authors.forename: Claudia
authors.initials: C
authors.lastname: Frankfurter
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D050110:Bariatric Surgery; D002170:Canada / Q000453:epidemiology; D003131:Combined Modality Therapy; D003657:Decision Making; D019468:Disease Management; D004704:Endocrinology; D005192:Family Health; D005194:Family Practice; D005260:Female; D013502:General Surgery; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery / Q000628:therapy; D010353:Patient Education as Topic; D010372:Pediatrics; D010820:Physicians / Q000523:psychology*; D010821:Physicians, Family / Q000523:psychology; D015995:Prevalence; D036301:Qualitative Research; D012017:Referral and Consultation