Trends and Correlates of Health Care Provider Identification of Overweight in Children Ages 2-15 in the U.S., 2001-2010.
Research Objective: Although screening children for overweight and obesity by health care providers (HCPs) has been recommended for several years, prevalence and trends related to child overweight identification by HCPs in rural/urban areas have not been assessed nationally. This study examined (1) whether rates of HCP identification of overweight and obesity have increased over time using a nationally representative sample of U.S. children and (2) explored contextual and individual correlates of HCP identification (e.g. rural/urban designation and child characteristics).
Study Design: Secondary analysis of data from the 2001-2008 National Health and Nutrition Examination Survey (NHANES). Age and sex-specific body mass index (BMI) percentiles were calculated according to the 2000 CDC growth charts. A caregiver reported whether a HCP had ever told them that their child was overweight. Other covariates included year, age, sex, race/ethnicity, and income-to-poverty ratio. The ERS Rural-Urban Continuum Codes were used to define rurality. Multivariate logistic regressions were used to examine whether the proportion of overweight and obese children identified by a HCP increased over time and rural/urban differences in likelihood of overweight identification by HCPs. Stata 12SE survey commands and appropriate sampling weights were used to account for the complex sampling design of NHANES.
Population Studied: The study population consisted of 12,255 children, ages 2-15 years. Approximately 59% of the sample was non-Hispanic White, 15% was non- Hispanic Black, 13% was Mexican-American, and 13% identified as other. About 18% of children were overweight (BMI % 85-94.9) and 11% were obese (BMI % 95+).
Principal Findings: Among overweight children, the proportion identified by a HCP did not change significantly in 2001-2006. The proportion identified in 2007-2008 (17%, SE: 1.8) was significantly higher than the proportion identified in 2001-2002 (8%, SE: 1.8). Using 2001-2002 as a reference point, the estimated adjusted odds of identification by a HCP were 2.3 times (95% CI: 1.3-3.9) higher in 2007-2008 (p
Conclusions: Although the proportion of overweight children identified by a HCP increased from 2001-2008, there is much room for improvement, particularly in the identification of overweight among younger children.
Implications for Policy, Delivery, or Practice: Identification of pediatric overweight is a necessary step toward prevention and treatment. As obesity is difficult to reverse, it is critical to identify children at risk and intervene at the earliest stages: (1) when children are very young, and (2) when children are in the pre-obesity category (i.e., overweight). Improved adherence to existing screening guidelines could help shift at-risk children toward a healthier weight trajectory.
Academy Health Annual Research Meeting (ARM)
Rossen, Lauren M., Yelena N. Tarasenko, Amy M. Branum, A. E. Simon, Kenneth C. Schoendorf.
"Trends and Correlates of Health Care Provider Identification of Overweight in Children Ages 2-15 in the U.S., 2001-2010.."
Epidemiology Faculty Presentations.