Effective Methods of Decreasing
the Incidence of Childhood Obesity
in the United States
By Kenya Baines and Stephanie Costa
Background
 The incidence of childhood obesity has been on the rise for the
last thirty years. Obesity is defined as a body mass index at or
above the 95th percentile. Seventeen percent of children ages 219 are obese.
 Obesity in children can lead to many health conditions including,
high blood pressure, high cholesterol, cardiovascular disease, type
2 diabetes, sleep apnea, asthma, fatty liver disease, gallstones,
GERD, and social and psychological problems such as
discrimination and poor self- esteem.
Obesity Complications
Problem Statement
 The role of effective interventions provided by health
care providers can have a positive impact in
decreasing these astronomical obesity related costs.
 Obesity rates continue to rise with a lack of information
related to the association of obesity with gender, age,
ethnicity and socioeconomic status.
Problem Statement
 Effective programs and policies are needed at a global,
regional and national level in order to decrease this
growing epidemic.
Research Question
 What interventions are effective in decreasing the
incidence of obesity in children of the United States
from childhood to adolescence?
Purpose of the study
 Is to reveal the effective treatment methods and
interventions needed to decrease childhood obesity
rates from childhood to adolescence.
 To enhance the practice of NP’s in relation to the
prevention of childhood obesity.
 To highlight effective guidelines of practice to be used
by the FNP to reduce the incidence of obesity.
Methodology
 20 articles were found. 9 were excluded. 11 articles were used in
the final draft of the literature review. 6 articles are used in our
presentation today.
 CINHAL, Google Scholar, Pub med
 Key search words: “childhood obesity” “prevention” “role of the
NP” “effective treatment methods”
 Inclusion criteria included that the article must relate to childhood
obesity in the United states
 Articles must address contribution to NP practice
 Exclusion criteria included any article that did not reference the
United States and did not provide research based on effective
treatment methods
Level Of Evidence
Author/
Article/
Year
Purpose
Sample (n) Design &
Level of
Evidence
Results
Larsen, L.,
Mandleco, B.,
Williams, M., &
Tiedeman, M.
Childhood
obesity:
prevention
practices of
nurse
practitioners.
(2006)
Describe the
prevention practices
of NP’s regarding
childhood obesity
and
compare/identify
relationships
between prevention
practices and
demographic
variables.
Convenience
sample of 99
FNP’s and
PNP’s.
Questionnaire
Level V
Although 73.7%
reported being
aware of
childhood
obesity
prevention
guidelines,
most were not
using the BMI
scale.
It is crucial that NP’s take
the necessary steps to
prevent childhood obesity
by following proper
guidelines.
Hessler, K., &
Siegrist, M.
Nurse
practitioner
attitudes and
treatment
practices for
childhood
overweight:
How do rural
and urban
practitioners
differ?
(2012)
To investigate NP’s
attitudes toward
pediatric obesity
and explore current
diagnosis and
treatment practices.
1088 FNP/PNP
chosen randomly
from the
American
Academy of NP’s
member list.
Cross sectional
design,
Level V
Did not assess
and diagnose
per current
guidelines.
Initiation of
treatment was
lacking. Rural
NP’s had fewer
referral
services.
More education for NP’s is
necessary. More referral
services needed.
Level of Evidence
Implications for
Practice
Author/
Article/
Year
Purpose
Sample (n)
Design &
Level of
Evidence
Results
Implications
for practice
Barlow, S., E., &
Dietz, W., H.
Management of
child and
adolescent obesity
(2002)
The primary aim of
this study was to
identify
interventions used
by pediatric health
care providers in
treatment of
overweight
children and
adolescents to
identify provider
educational needs.
Randomized, 940
providers
Questionnaire,
Level V
The majority
recommended
"changes in
eating patterns"
and "limitations
of low-fat diet"
and "modest
calorie
restriction" in
adolescents.
The NPs in this study
promoted healthy
eating and activity
with minimal use of
highly restrictive diets
or medication to
control weight.
Davis, M. M.,
Gance-Cleveland,
B., Hassink, S.,
Johnson, R.,
Paradis, G., &
Resnicow, K.
Recommendations
for Prevention of
Childhood Obesity.
(2007)
Reviewed the
most recent
evidence
regarding many
behavioral and
practice
interventions
related to
childhood obesity,
and presented
recommendations
to health care
providers.
Not listed
Literature review,
Level V
Suggested
approaches
that clinicians
can use to
encourage
obesity
prevention
among
children,
including
specific
counseling
strategies and
practice-based,
systems-level
interventions.
One of the most
beneficial methods is
when NP’s interact
with and promote
local and state policy
initiatives designed to
prevent obesity in
their communities.
Author/
Article/
Year
Purpose
Sample (n)
Design &
Level of
Evidence
Results
Implication
s for
Practice
Heitmann, B. L.,
Koplan, J., &
Lissner, L.
Childhood obesity:
successes and
failures of
preventive
interventions.
(2009)
This report
summarizes the
main points of the
session titled
“Prevention of
Childhood
Obesity” held at
the World
Congress of
Public Health
Nutrition
Not listed
Literature review,
Level V
The speakers
were in general
agreement that
action is needed in
the area of
childhood obesity
prevention and
that the worldwide
epidemic itself is
sufficient evidence
for action.
Important issues
here include
establishing a
consensus on
what constitutes a
good, yet realistic,
design and on
how to maintain
scientific
standards in
community
interventions.
Hopkins, K., F.,
DeCristofaro, C.,
& Elliott, L. How
can primary care
providers manage
pediatric obesity in
the real
world? (2011)
To provide
evidence-based
interventions and
clinical practice
guidelines as a
basis for a clinical
toolkit utilizing a
step management
approach for the
primary care
provider in
managing
childhood obesity.
Not listed
Literature review,
Level V
For all treatments,
lifestyle
modifications
include attention
to diet and activity
level.
Using current
guidelines, the
primary care
provider can
initiate and
manage ongoing
interventions in
pediatric obesity.
Emerging Themes
 Prevention is key!
 Following clinical guidelines, such as the BMI scale is
important for assessing children at risk.
 NP’s must be educated on the importance of using the
correct clinical guidelines.
 Pay attention to family cues and develop a plan that will
work best for the patient and the family as a whole.
 NP’s should get involved in prevention of childhood
obesity at a community level.
Contribution to NP practice
 Family nurse practitioners face many barriers when
implementing education related to the prevention of
childhood obesity.
 Childhood obesity is increasing at a staggering rate in
the United States and it is imperative that we as
primary care providers, take the initiative in using the
proper steps for prevention.
 Calculating the BMI for age, targeting children at risk,
as well as helping families develop healthy nutrition
and exercise plans.
Contribution to NP practice
 NP's should act as advocates in their communities to
help overcome the major barriers that are linked to
childhood obesity prevention.
 Nurse practitioners are at the forefront for assessing,
diagnosing and treating childhood obesity.
Planned Methodology
 To continue our search for effective treatment methods
using library databases.
 Adhere to our inclusion/exclusion criteria.
 Look for more community resources.
 Gather more data related to NP’s in our community.
References
Barlow, S., E., & Dietz, W., H. (2002). Management of child and adolescent obesity: Summary and
recommendations based on reports from pediatricians, pediatric nurse practitioners, and
registered dietitians. Pediatrics, 110(Supplement), 236-238.
Basics about Childhood Obesity. (2012, April 27). Retrieved February 1, 2015, from
http://www.cdc.gov/obesity/childhood/basics.html
Childhood obesity facts. (2014, December 11). Retrieved February 1, 2015, from
http://www.cdc.gov/healthyyouth/obesity/facts.htm
Davis, M. M., Gance-Cleveland, B., Hassink, S., Johnson, R., Paradis, G., & Resnicow, K. (2007,
Dec 1). Recommendations for Prevention of Childhood Obesity. PEDIATRICS, 120, 229-253.
http://dx.doi.org/10.1542/peds.2007-2329E
Heitmann, B. L., Koplan, J., & Lissner, L. (2009). Childhood obesity: successes and failures of
preventive interventions. Nutrition Reviews, 67, 89-93. http://dx.doi.org/10.1111/j.17534887.2009.00167.x
Hessler, K., & Siegrist, M. (2012, February 24). Nurse practitioner attitudes and treatment practices
for childhood overweight: How do rural and urban practitioners differ? Journal of the American
Academy of Nurse Practitioners, 2, 97-106.
http://dx.doi.org/http://dx.doi.org.ezproxy.simmons.edu:2048/10.1111/j.1745-7599.2011.00673.x
Hopkins, K., F., DeCristofaro, C., & Elliott, L. (2011). How can primary care providers manage
pediatric obesity in the real world? Journal of the American Academy of Nurse
Practitioners, 23(6), 278-288.
References
Larsen, L., Mandleco, B., Williams, M., & Tiedeman, M. (2006, February). Childhood obesity:
prevention practices of nurse practitioners. Journal of the American Academy of Nurse
Practitioners, 2, 70-99.
http://dx.doi.org/http://dx.doi.org.ezproxy.simmons.edu:2048/10.1111/j.17457599.2006.00105.x
Sonneville, K., LaPelle, N., Taveras, E., Gillman, M., & Prosser, L. (2009). Economic and
other barriers to adopting recommendations to prevent childhood obesity: Results of a
focus group study with parents. BMC Pediatrics, 9
Story, M., T., Neumark-Stzainer, D., R., Sherwood, N., E., Holt, K., Sofka, D., Trowbridge, F.,
L., et al. (2002). Management of child and adolescent obesity: Attitudes, barriers, skills,
and training needs among health care professionals. Pediatrics, 110, 210-214.
Trasande, L., Liu, Y., Fryer, G., & Weitzman, M. (2009). Effects of childhood obesity on
hospital care and costs, 1999–2005. Retrieved from
http://content.healthaffairs.org/content/28/4/w751.
Wang, Y., & Lobstein, T. (2006, March). Worldwide trends in childhood overweight and
obesity. International Journal of Pediatric Obesity, 1, 11-25.
http://dx.doi.org/10.1080/17477160600586747