Empowering Clinicians As Advocates Against Childhood Obesity

Background:  Nearly a third of U.S. children and adolescents are overweight or obese. Strategies to address childhood obesity include prevention and intervention approaches at the patient, family, and community level, as well as tactics that affect cultural and policy environments. Clinicians can take steps to improve their patients’ health not only at the individual level, but by advocating for healthier communities.

Program background:  In partnership with The California Endowment, Medscape developed a four-part continuing education curriculum for physicians and nurses that outlined the epidemiology of pediatric overweight and obesity nationally and in California, clinical and lifestyle interventions for patients and families, and steps clinicians can take to become advocates for obesity prevention. These programs launched in summer 2013 and attracted more than 5300 clinician learners within California and more than 44,000 nationwide in the first six months.

Evaluation Methods and Results:  Learners who participated in two activities were asked to complete a Planned Change Assessment survey indicating what professional changes they planned to initiate as a result of these activities. Among 2811 survey respondents:

• 75% indicated they intend to discuss negative effects of sugary drinks with children and their parents
• 48% indicated they planned to encourage health-promotion practices within their healthcare systems
• 53% indicated they would support policy changes that encourage community equity, such as discouraging advertising of fast food to children in low-income communities
• 53% indicated they would assess their patients’ environmental and economic barriers to healthy eating and physical activity

On average, learners selected 3.6 planned changes to undertake. The 165 learners who completed a follow-up survey approximately 8 weeks after completion of the activities averaged 4 completed changes:

• 94% discuss negative effects of sugary drinks with children and their parents
• 88% encourage health-promotion practices within their health systems
• 63% support policy changes that encourage community equity, such as discouraging advertising of fast food to children in low-income communities
• 50% assess their patients’ environmental and economic barriers to healthy eating and physical activity

Many respondents to the follow-up survey indicated that they already performed a number of these behaviors, while others reported engaging in them more consistently.

Conclusions:  This curriculum, which blended epidemiology, clinical and policy-related learning objectives, was most effective in prompting physicians to discuss the effects of sugary beverages with their patients, encourage healthy practices within their own health system, and intensify the role of clinicians as advocates for healthy eating and physical activity. Based on self-reported data from follow-up survey completers, the activities encouraged clinicians to take on new approaches to preventing obesity or follow best practices more consistently.

Implications for research and/or practice:  Future investigation options include attempting to reproduce these findings with similar curricula built for specific regions with large youth populations, focusing on local policy environments and cultural makeup.