Provider Practice and Perceptions of Pediatric Obesity in Appalachian Kentucky

Abstract

Pediatric obesity continues to be a significant and costly clinical concern, especially in the rural primary care settings of Appalachian Kentucky. This article discusses a survey of primary care providers in eastern Kentucky that assesses current practice, perceived barriers, and perceived needs in the prevention, screening, and treatment of pediatric obesity. Results indicate the inconsistent implementation of Expert Committee guidelines, especially in regard to addressing patient motivation and psychological sequelae. Implications for training, policy, and integration with behavioral health experts are discussed. Objectives This study assessed providers’ present practices and perceived needs in Appalachian Kentucky to identify the standard of care and implementation of expert recommendations for managing pediatric obesity. Methods Questionnaire data were gathered from 28 providers at a pediatric obesity continuing medical education workshop in eastern Kentucky. We assessed current practices, perceived barriers to treatment, and needed resources for managing pediatric obesity. Results Respondents reported mixed adherence to expert recommendations, with providers less frequently addressing family-reported barriers to change and assessing a family’s readiness to change behaviors related to pediatric obesity. Respondents also reported service barriers related to patient motivation, lack of time with patients, and a lack of referral options. Finally, providers reported needing multiple community resources to better address pediatric obesity, including improved physical education programs, access to community recreation centers, additional referral resources for multidisciplinary care, and additional training in motivational techniques. Conclusions There remains a significant need for education and guidance regarding the implementation of expert recommendations for addressing pediatric obesity in Appalachian Kentucky. Providers reported needing multiple community resources, including improved physical education programs, access to community recreation centers, additional referral resources for multidisciplinary care, and additional training in motivational techniques. We discuss the implications for disseminating and implementing expert recommendations in rural eastern Kentucky, with an emphasis on the roles of behavioral health experts.