Background: Previous studies have identified attending physicians’ perceptions regarding screening for and managing pediatric obesity, but less is known about resident physicians’ perspectives and perceived barriers. Identifying barriers to effective counseling on obesity prevention and management can help direct resident education and will be beneficial for both residents and their patients. The objective of this study was to assess pediatric residents’ knowledge on obesity screening, their comfort discussing obesity with families, their self-efficacy regarding obesity prevention and management, and the barriers they face discussing obesity with patients. Methods: An anonymous survey was electronically distributed to residents at an academic continuity practice. The survey contained multiple choice and open-ended questions based on the AAP’s 2007 Expert Committee Recommendations on Obesity and extensive literature review conducted by the authors; questions assessed knowledge, attitudes, and barriers to discussing and managing obesity at preventive visits. Descriptive data and Spearman correlation coefficients were calculated; comparisons were performed using χ2 or ANOVA. The study was deemed exempt by the Icahn School of Medicine IRB. Results: 49 of 58 residents (84%) completed the survey. Mean score on the knowledge questions was 52.7%. Knowledge did not significantly differ by training level. 71.4% of residents felt “somewhat” or “very” well-prepared to counsel families about obesity; 77.6% felt “somewhat” or “very” comfortable discussing overweight/obesity with patients with these diagnoses. In contrast, 77.6% of residents thought their counseling on overweight/obesity management was “not at all” or “slightly” effective and 69.4% thought their counseling on obesity prevention was “not at all” or “slightly” effective. Higher training level was associated with feeling more prepared to counsel families about obesity than lower training level (P=0.003). Insufficient time (77.6%), inadequate training (55.1%), and concern for hurting parents’/patients’ feelings (55.1%) were the most common barriers to discussing obesity at preventive visits. Higher scores on knowledge questions suggest a correlation with greater comfort discussing overweight/obesity (r=0.31, P=0.03) and self-perceived effectiveness in prevention counseling (r=0.30, P=0.04). Conclusion: Similar to attending physicians, most residents felt well-prepared to counsel families about obesity and comfortable discussing obesity with them. The majority of residents also did not think their counseling on obesity management or prevention was effective. Further study is needed to determine if residents’ self-perceived effectiveness impacts patient outcomes. Improving resident knowledge, teaching strategies such as motivational interviewing, and enhancing clinic resources may help to improve obesity management.
Resident physicians’ knowledge and attitudes regarding obesity management
Resident physicians’ barriers to discussing obesity at preventive visits