Paper
Friday, 21 July 2006
This presentation is part of : Primary Care Strategies and Instruments
Screening Tool for Identification of Overweight Children and Adolescents
Patricia Powers, MS, FNP, PMHNP and Joyce Scarpinato, MS, APRN, PNP, BC. College of Nursing, Upstate Medical University, Syracuse, NY, USA
Learning Objective #1: identify guidelines/recommendations for overweight children and adolescence in the primary care setting
Learning Objective #2: implement the screening tool for overweight children and adolescents in the primary care setting
Introduction:      The purpose of this project is to develop a screening tool to guide primary care providers in the identification of overweight children and adolescents.

Background:     One in five children in the United States is considered overweight and at increased risk for co-morbid conditions including hypertension, impaired glucose tolerance, obstructive sleep apnea and dyslipidemia.  Pediatric obesity is one of the most difficult diseases to treat in this population.  For this reason, the Maternal and Child Health Bureau, Department of Health and Human Services and Health Resources and Services Administration met in an effort to provide guidance for practitioners and other personnel who care for obese children.  The Committee reached a consensus and developed recommendations regarding the evaluation and treatment of childhood obesity.  The Expert Committee on Childhood Obesity recommendations were published in Pediatric (1998) and similar recommendations are available through the American Academy of Family Physicians (AAFP).    

Method:     A review of literature in studies on screening for childhood and adolescent obesity in the primary care setting was conducted through a focused search utilizing the Ovid Medline, CINAHL, and Cochrane Database.  Key words used were “childhood,” and “youth” and “adolescent” combined with obesity and overweight.  Other key words included primary care, screening, screening tool or co morbidities.

Implications:     Randomized and cohort studies show screening recommendations for childhood and adolescent obesity are presently underutilized. A significant study by Barlow (2002) suggests that less than 10% of practitioners in pediatric primary care follow recommendations for history and physical examinations. Another similar study by Lakshmi (2004) identified only 19% of practitioners were aware of either the 1998 Expert Committee or AAFP recommendations.   Development of a screening tool utilizing recommendations will assist practitioners in identifying and documenting overweight children and adolescents who are at risk for related co-morbid disorders.     

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