Scaling-Up Stage 4 Pediatric Obesity Clinics: Identifying Barriers and Future Directions Using Implementation Science.
Adolescent
Ambulatory Care Facilities
/ organization & administration
Child
Child, Preschool
Delivery of Health Care, Integrated
/ organization & administration
Health Plan Implementation
/ methods
Health Services Accessibility
/ organization & administration
Humans
Implementation Science
Pediatric Obesity
/ epidemiology
Research Design
Telemedicine
United States
/ epidemiology
Journal
Obesity (Silver Spring, Md.)
ISSN: 1930-739X
Titre abrégé: Obesity (Silver Spring)
Pays: United States
ID NLM: 101264860
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
25
01
2021
received:
15
12
2020
accepted:
01
02
2021
pubmed:
28
4
2021
medline:
25
6
2021
entrez:
27
4
2021
Statut:
ppublish
Résumé
Nearly one-fifth of the pediatric population in the United States has obesity. Comprehensive behavioral interventions, with at least 26 contact hours, are the recommended treatment for pediatric obesity; however, there are various barriers to implementing treatment. This Perspective applies the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to address barriers to implementing multidisciplinary pediatric weight management clinics and identify potential solutions and areas for additional research. Lack of insurance coverage and reimbursement, high operating costs, and limited access to stage 4 care clinics with sufficient capacity were among the main barriers identified. Clinicians, researchers, and patient advocates are encouraged to facilitate conversations with insurance companies and hospital and clinic administrators, increase telehealth adoption, request training to improve competency and self-efficacy discussing and implementing obesity care, and advocate for more stage 4 clinics.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
941-943Informations de copyright
© 2021 The Obesity Society (TOS).
Références
US Preventive Services Task Force; Grossman DC, Bibbins-Domingo K, Curry SJ, et al. Screening for obesity in children and adolescents US Preventive Services Task Force recommendation statement. JAMA 2017;317:2417-2426.
ConscienHealth. Childhood obesity treatment programs: a few to serve many. Published February 7, 2017. Accessed October 21, 2020. https://conscienhealth.org/2017/02/childhood-obesity-treatment-programs-serve-many/
Eneli I, Norwood V, Hampl S, et al. Perspectives on obesity programs at children’s hospitals: insights from senior program administrators. Pediatrics 2011;128(suppl 2):S86-S90.
Hampl SE, Davis AM, Sampilo ML, Stephens KL, Dean K. Insurer and employer views on pediatric obesity treatment: a qualitative study. Obesity (Silver Spring) 2013;21:795-799.
Bauer MS, Kirchner JA. Implementation science: what is it and why should I care? Psychiatry Res 2020;283:112376. doi:10.1016/j.psychres.2019.04.025
Moullin JC, Dickson KS, Stadnick NA, Rabin B, Aarons GA. Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Implement Sci 2019;14:1. doi:10.1186/s13012-018-0842-6
Hoffman J, Frerichs L, Story M, et al. An integrated clinic-community partnership for child obesity treatment: a randomized pilot trial. Pediatrics 2018;141:e20171444. doi:10.1542/peds.2017-1444
National Conference of State Legislatures. Childhood overweight and obesity trends. Published February 26, 2014. Accessed October 21, 2020. https://www.ncsl.org/research/health/childhood-obesity-trends-state-rates.aspx
Borner KB, Canter KS, Lee RH, Davis AM, Hampl S, Chuang I. Making the business case for coverage of family-based behavioral group interventions for pediatric obesity. J Pediatr Psychol 2016;41:867-878.
Cardel MI, Jastreboff AM, Kelly AS. Treatment of adolescent obesity in 2020. JAMA 2019;322:1707-1708.