Pediatric Obesity Column
Childhood obesity rates continue to remain a concern for clinicians with 22.8% of children 2–5 years old and 34.2% of children 6–11 years old affected. Prevalence rates are often highest among Black and Latino children (Hoelscher et al., 2015). These children will have an increased risk of cardiovascular disease, metabolic and endocrine disorders, depression, and bullying. The physical, psychosocial, and financial implications of childhood obesity cannot be ignored, yet many healthcare providers are often limited in the time and resources needed to address the problem. A common obstacle that healthcare providers face includes a lack of familiarity about community resources for lifestyle counseling and obesity prevention programs (Vine, Hargreaves, Briefel, & Orfield, 2013). As a result, many approach childhood obesity prevention by simply providing education and handouts on healthy eating and exercise strategies to families at the end of a clinical encounter. Childhood obesity prevention is often focused on individual lifestyle changes, such as providing teaching on the recommended amount of exercise for a child. This approach may result in short-term behavior changes that suggest an improvement in healthy lifestyle decisions, yet evidence suggests that these approaches may not have a “significant or sustainable impact” (Fialkowski et al., 2014). For example, providing education on the need for 60 minutes of exercise without thinking of a child's built environment may result in ineffective behavior change if the child has limited access to a safe place to play. Effective childhood obesity prevention strategies should take into account social, cultural, political, and environmental domains. Interventions that use an ecological approach to target the individual, social, and built environments have the ability to influence a larger population and provide long-term impact (Fialkowski et al., 2014).
Healthcare providers have an important role in providing standardized care for healthy community environments and ensuring access to routine obesity prevention screening, diagnosis, and treatment (Vine et al., 2013). In addition, providers should focus on referral of patients to community-based programs outside acute and primary care settings, dissemination of healthy lifestyle suggestions as part of prevention efforts in the community setting, and multisector community initiatives to achieve policy goals and support policy change in the broader community setting (Vine et al., 2013).
Community partnerships can more effectively address complex problems by strengthening the children's environment to promote healthy food choices and active play to prevent childhood obesity (Fialkowski et al., 2014). Action steps providers can take to improve community resources for the families they serve may include meeting with key informants to learn about community programs and developing a shared vision for healthy lifestyles. Providers may also consider developing local advisory committees to provide guidance and support on childhood obesity prevention activities.
There is a robust body of knowledge supporting childhood obesity prevention and intervention strategies that encourage healthy lifestyle decisions in families using community partnerships, yet knowledge and access about such programs may be limited in busy clinical settings. Identifying resources that teach families ways to make lifestyle changes that are sustainable in their own homes and communities is needed for effective change. The creation of a multidisciplinary partnership of pediatric healthcare providers and community resources bridges this gap and provides diverse perspectives to increase the effectiveness of childhood obesity prevention strategies on a larger scale.
Fialkowski M. K., DeBaryshe B., Bersamin A., Nigg C., Guerrero R. L., Rojas G., … Novotny R. (2014). A community engagement process identifies environmental priorities to prevent early childhood obesity: The children's healthy living (CHL) program for remote underserved populations in the US affiliated pacific islands, Hawaii and Alaska. Maternal and Child Health Journal
, 18(10), 2261–2274.
Hoelscher D. M., Butte N. F., Barlow S., Vandewater E. A., Sharma S. V., Huang T., … Kelder S. H. (2015). Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: Study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Childhood Obesity
, 11(1), 71–91.
Vine M., Hargreaves M. B., Briefel R. R., & Orfield C. (2013). Expanding the role of primary care in the prevention and treatment of childhood obesity: A review of clinic- and community-based recommendations and interventions. Journal of Obesity
, 2013, 172035.