Perception and documentation of weight management practices in pediatric primary care.

BACKGROUND: Pediatric obesity is a significant problem in the United States. The Childhood Obesity Action Network (COAN) published expert recommendations in 2007 for pediatric obesity prevention and assessment at well-child visits. The purpose of this study was to assess pediatric providers' perception and documentation of their adherence to the 2007 COAN guidelines. METHODS: This was a 2-part cross sectional research study. A 36-item questionnaire about screening and management of obesity was sent to 69 providers from 16 pediatric practice sites in Southeastern Wisconsin. A retrospective chart review of well-child visits performed in June 2012 was conducted. RESULTS: Discrepancies were found between what providers reported and documented for their obesity screening management and anticipatory guidance that they provided. In addition, the majority of providers reported inadequacy and lack of comfort when working with overweight or obese patients. Patient compliance and motivation were reported as barriers to obesity management. CONCLUSION: Discrepancies exist between providers' self-report and documentation of obesity screening and management. In addition, providers report discomfort in managing obesity. Tools to improve documentation and continued education to improve provider comfort in managing obesity are imperative steps in optimizing care.