supporting physicians with education and know-how in identifying and motivating overweight kids

Conditions: Obesity

Summary: the proposed study is a randomized control trial evaluating the efficacy of two training programs in increasing physician identification, documentation, and motivation of overweight children. pediatric primary care physicians will be recruited from the college of physician and surgeons of ontario and randomized into two practice-based interventions (behavioural/educational) which are a one-time training attendance. the educational intervention will focus on the medical management of pediatric obesity, the use of body mass index charts, and information about how obese children would like to be approached by their physicians. the behavioural intervention will incorporate motivational interviewing tools in addition to an abbreviated training program received by the educational intervention group.

there are no prospective, randomized clinical studies on training physicians to effectively manage pediatric obesity using both motivational interviewing (mi) tools and advice from overweight children. a novel aspect of this study is that the skills taught during the trainings are made so that physician can easily incorporate them into their busy practice. the generated findings from focus groups with obese children, merged guidelines for the medical management of childhood obesity, and training in specific mi tools, also make this study unique. primary objective: to determine which of two interventions (behavioural/education) is most effective in increasing discussion initiation around weight with overweight children by calculating, plotting, and tracking bmi, and increasing self-reported efficacy in counseling overweight pediatric patients. hypothesis: the behaviour change intervention will be most effective because it will achieve greater changes in the above mentioned behaviours that are maintained for 6 to 12 months. these outcomes will be influenced by counselling efficacy, frequency, and type of reported barriers and not physician demographics. secondary objectives: to evaluate current physician practices of bmi calculating, plotting and/or tracking, and discussion initiation with overweight pediatric patients, and the factors that influence these behaviours. hypothesis: physicians do not consistently calculate, plot, and/or track bmi and/or discuss weight with their pediatric patients. these practices will be primarily influenced by physicians' characteristics, counselling efficacy, frequency and type of reported barriers

Eligibility criteria:
inclusion criteria: 1. toronto area pediatricians and family physicians who are members of the college of physicians and surgeons of ontario 2. available to attend workshop at the hospital for sick children 3. pediatric patient population of at least 25% (office audit to be completed by office staff) (to ensure sufficient contact with children and their families 4. no sub-specialty practice in obesity or related co-morbidities (this study is aimed at changing communication in primary care offices for well-child patient visits) exclusion criteria: n/a

Keywords: pediatric childhood obesity motivational interviewing pediatric primary care physicians