Perceived barriers, resources, and training needs of rural primary care providers relevant to the management of childhood obesity.
PURPOSE
To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity.


METHODS
In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded.


RESULTS
Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics.


CONCLUSIONS
Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings.
['Findholt|Nancy E|NE|', 'Davis|Melinda M|MM|', 'Michael|Yvonne L|YL|']
D005260:Female D006295:Health Resources D006297:Health Services Accessibility D006801:Humans D008297:Male D009765:Obesity D009922:Oregon D058007:Physicians, Primary Care D036301:Qualitative Research D019035:Rural Health Services
rural childhood obesity primary care practice qualitative research