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[PMID]: | 27453375 |
[Au] Autor: | Robson SM; Bolling C; McCullough MB; Stough CO; Stark LJ |
[Ad] Endereço: | Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. |
[Ti] Título: | A Preschool Obesity Treatment Clinical Trial: Reasons Primary Care Providers Declined Referrals. |
[So] Source: | J Pediatr;177:262-266.e1, 2016 Oct. | [Is] ISSN: | 1097-6833 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | OBJECTIVE: To examine referral by primary care providers (PCPs) of preschool children with obesity (≥95th percentile for body mass index [BMI]) to a weight management intervention when offered through a randomized clinical trial (RCT), and identify reasons for not referring children. STUDY DESIGN: In phase I, 3 experts in obesity, psychology, and nutrition completed an open card sort and classified PCPs' reasons for declining referral into groups based on similarity of reasons. Categories were then defined and labeled. In phase II, 2 independent sorters placed each decline into 1 of the categories defined in phase I. RESULTS: PCPs referred 78% of eligible children to the RCT. Compared with children declined for referral, referred children had a significantly higher weight (48.4 lb vs 46.1 lb; P < .001) and BMI percentile (97.6 vs 97.0; P < .001). Eleven categories for decline were identified in phase I. In phase II, excellent reliability was obtained between each independent sorter and the phase I categories, and also between the 2 independent sorters (κ values, 0.72-1.0). The most common reason for declining was "family not a good fit" (23.6%), followed by "doesn't believe weight is a problem" (13.9%), "family would not be interested" (12%), and "doesn't believe measurement is accurate" (11.5%). Appropriately, exclusionary criteria of the RCT was a reason as well (11.8%). CONCLUSION: The availability of weight management for preschoolers through RCTs appeared to overcome barriers of resources, time, and credible treatment cited in previous studies. However, concerns about the family's response or interest in a weight management program remained barriers, as did PCPs' perceptions about obesity in young children. TRIAL REGISTRATION: ClinicalTrials.gov:NCT01546727. |
[Mh] Termos MeSH primário: |
Obesidade Pediátrica/terapia Atenção Primária à Saúde Encaminhamento e Consulta Recusa de Participação
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[Mh] Termos MeSH secundário: |
Pré-Escolar Feminino Seres Humanos Masculino Meia-Idade
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
[Em] Mês de entrada: | 1706 |
[Cu] Atualização por classe: | 171001 |
[Lr] Data última revisão:
| 171001 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 160726 |
[Cl] Clinical Trial: | ClinicalTrial
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[St] Status: | MEDLINE |
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