Perceived Barriers, Resources, and Training Needs of Rural Primary Care Providers Relevant to the Management of Childhood Obesity
Perceived Barriers, Resources, and Training Needs of Rural Primary Care Providers Relevant to the Management of Childhood Obesity
复制标题
DOI：
10.1111/jrh.12006
复制
发表时间：
2013-08-01
影响因子：
4.9
通讯作者：
Michael, Yvonne L.
中科院分区：
文献类型：
--
作者：
Findholt, Nancy E.;Davis, Melinda M.;Michael, Yvonne L.
PurposeTo探讨感知障碍，资源和培训需求的农村初级保健提供者在实施美国医学会专家委员会的建议，评估，治疗和预防儿童obesity. MethodsIn深入访谈进行了13个农村初级保健提供者在俄勒冈州。转录采访的主题coded.ResultsBarriers解决儿童肥胖分为5类：与这种做法有关的障碍（时间限制，缺乏报销，很少有机会发现肥胖），临床医生（知识有限）、家属/患者（家庭生活方式和父母缺乏改变的动力，家庭收入低和缺乏健康保险，问题敏感），社区（缺乏儿科专科医生和多学科/三级保健服务，社区资源很少）和更广泛的社会文化环境（社会文化影响，儿童肥胖症高发）。很少有诊所和社区资源来帮助临床医生解决体重问题。临床医生很少收到以前的培训有关儿童肥胖症，他们表示有兴趣在几个topics.ConclusionsRural初级保健提供者面临广泛的障碍，在实施建议的做法，评估，治疗和预防儿童肥胖症。尤其是缺乏地方和区域资源。雇用护士提供病例管理和行为咨询，小组访问，远程保健和其他技术通信的战略，可以改善儿童肥胖的管理，在农村初级保健设置。
PurposeTo explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity.MethodsIn-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded.ResultsBarriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics.ConclusionsRural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings.