Skip to main content
Erschienen in: Current Nutrition Reports 4/2013

01.12.2013 | Public Health and Translational Medicine (PW Franks, Section Editor)

Tailoring Health Services for Managing Pediatric Obesity: A Proposed, Practice-Based Framework for Working with Families

verfasst von: Rachel A. Keaschuk, Geoff D. C. Ball

Erschienen in: Current Nutrition Reports | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

Abstract

To optimize the likelihood of success, guidelines for managing pediatric obesity recommend using family-based strategies, focusing on improvements in lifestyle and behavioral factors, and matching health services to families’ (children’s, adolescents’, and parents’) motivation to change. To date, there has been little specific guidance for clinicians to operationalize the directive to tailor their counseling to families’ motivation (readiness, willingness, and ability) to change obesogenic habits. In this paper, we propose a conceptual heuristic that clinicians can use to tailor intervention approaches to a family’s motivation to change obesogenic lifestyle and behavioral factors. Insight regarding families’ motivation and developmental capabilities needed to implement changes are the foundation of our proposed model, which is informed by Prochaska’s Transtheoretical Model and Stages of Change. This practical framework can help to reduce the complexity of pediatric obesity and to guide clinicians in working with families efficiently and effectively.
Literatur
1.
Zurück zum Zitat • Roberts KC, Shields M, de Groh M, et al. Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2012;23:37–41. This article provides the most recent data on the prevalence of overweight and obesity in Canadian boys and girls using measured anthropometric data. PubMed • Roberts KC, Shields M, de Groh M, et al. Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2012;23:37–41. This article provides the most recent data on the prevalence of overweight and obesity in Canadian boys and girls using measured anthropometric data. PubMed
2.
Zurück zum Zitat Skelton JA, Cook SR, Auginer P, et al. Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr. 2009;9:322–9.PubMedCrossRef Skelton JA, Cook SR, Auginer P, et al. Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr. 2009;9:322–9.PubMedCrossRef
3.
Zurück zum Zitat Wang YC, Gortmaker SL, Taveras EM. Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006. Int J Pediatr Obes. 2009;6:12–20.CrossRef Wang YC, Gortmaker SL, Taveras EM. Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006. Int J Pediatr Obes. 2009;6:12–20.CrossRef
4.
Zurück zum Zitat Singh AS, Mulder C, Twisk JW, et al. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9:474–88.PubMedCrossRef Singh AS, Mulder C, Twisk JW, et al. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9:474–88.PubMedCrossRef
5.
Zurück zum Zitat Cruz ML, Shaibi GQ, Weigensberg MJ, et al. Pediatric obesity and insulin resistance: chronic disease risk and implications for treatment and prevention beyond body weight modification. Annu Rev Nutr. 2005;25:435–68.PubMedCrossRef Cruz ML, Shaibi GQ, Weigensberg MJ, et al. Pediatric obesity and insulin resistance: chronic disease risk and implications for treatment and prevention beyond body weight modification. Annu Rev Nutr. 2005;25:435–68.PubMedCrossRef
6.
Zurück zum Zitat Franks PW, Hanson RL, Knowler WC, et al. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med. 2010;362:485–93.PubMedCrossRef Franks PW, Hanson RL, Knowler WC, et al. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med. 2010;362:485–93.PubMedCrossRef
7.
Zurück zum Zitat Tremblay MS, Shields M, Laviolette M, et al. Fitness of Canadian children and youth: results from the 2007–2009 Canadian Health Measures Survey. Health Rep. 2010;21:7–20.PubMed Tremblay MS, Shields M, Laviolette M, et al. Fitness of Canadian children and youth: results from the 2007–2009 Canadian Health Measures Survey. Health Rep. 2010;21:7–20.PubMed
8.
Zurück zum Zitat Wang F, Wild TC, Kipp W, et al. The influence of childhood obesity on the development of self-esteem. Health Rep. 2009;20:21–7.PubMed Wang F, Wild TC, Kipp W, et al. The influence of childhood obesity on the development of self-esteem. Health Rep. 2009;20:21–7.PubMed
9.
Zurück zum Zitat Puhl RM, Latner JD. Stigma, obesity, and the health of the nation’s children. Psychol Bull. 2007;133:557–80.PubMedCrossRef Puhl RM, Latner JD. Stigma, obesity, and the health of the nation’s children. Psychol Bull. 2007;133:557–80.PubMedCrossRef
10.
Zurück zum Zitat Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004;113:1187–94.PubMedCrossRef Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004;113:1187–94.PubMedCrossRef
11.
Zurück zum Zitat Lau DC, Douketis JD, Morrison KM, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176:S1–S13.PubMedCrossRef Lau DC, Douketis JD, Morrison KM, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176:S1–S13.PubMedCrossRef
12.
Zurück zum Zitat Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164–92.PubMedCrossRef Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164–92.PubMedCrossRef
13.
Zurück zum Zitat Wagner EH, Austin BT, Davis C, et al. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20:64–78.CrossRef Wagner EH, Austin BT, Davis C, et al. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20:64–78.CrossRef
14.
Zurück zum Zitat Wagner EH, Davis C, Schaefer J, et al. A survey of leading chronic disease management programs: are they consistent with the literature? Manag Care Q. 1999;7:56–66.PubMed Wagner EH, Davis C, Schaefer J, et al. A survey of leading chronic disease management programs: are they consistent with the literature? Manag Care Q. 1999;7:56–66.PubMed
15.
Zurück zum Zitat Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12:e273–81.PubMedCrossRef Skelton JA, Beech BM. Attrition in paediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12:e273–81.PubMedCrossRef
16.
Zurück zum Zitat Edwards NM, Schwarzenberg SJ. Designing and implementing an effective pediatric weight management program. Rev Endocr Metab Disord. 2009;10:197–203.PubMedCrossRef Edwards NM, Schwarzenberg SJ. Designing and implementing an effective pediatric weight management program. Rev Endocr Metab Disord. 2009;10:197–203.PubMedCrossRef
17.
Zurück zum Zitat Drieschner KH, Lammers SM, van der Staak CP. Treatment motivation: an attempt for clarification of an ambiguous concept. Clin Psychol Rev. 2004;23:1115–37.PubMedCrossRef Drieschner KH, Lammers SM, van der Staak CP. Treatment motivation: an attempt for clarification of an ambiguous concept. Clin Psychol Rev. 2004;23:1115–37.PubMedCrossRef
18.
Zurück zum Zitat Ball GD, Perez Garcia A, Chanoine JP, et al. Should I stay or should I go? Understanding families’ decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: the protocol for a multi-center, qualitative study. BMC Health Serv Res. 2012;12:486.PubMedCrossRef Ball GD, Perez Garcia A, Chanoine JP, et al. Should I stay or should I go? Understanding families’ decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: the protocol for a multi-center, qualitative study. BMC Health Serv Res. 2012;12:486.PubMedCrossRef
19.
Zurück zum Zitat Gunnarsdottir T, Njardvik U, Olafsdottir AS, et al. The role of parental motivation in family-based treatment for childhood obesity. Obesity. 2011;19:1654–62.PubMedCrossRef Gunnarsdottir T, Njardvik U, Olafsdottir AS, et al. The role of parental motivation in family-based treatment for childhood obesity. Obesity. 2011;19:1654–62.PubMedCrossRef
20.
Zurück zum Zitat Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice Hall; 1987. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice Hall; 1987.
21.
Zurück zum Zitat Rollnick S. Behaviour change in practice: targeting individuals. Int J Obes Relat Metab Disord. 1996;20 Suppl 1:S22–6.PubMed Rollnick S. Behaviour change in practice: targeting individuals. Int J Obes Relat Metab Disord. 1996;20 Suppl 1:S22–6.PubMed
22.
Zurück zum Zitat Prochaska JO, Velicer WF. The Transtheoretical Model of health behavior change. Am J Health Promot. 1997;12:38–48.PubMedCrossRef Prochaska JO, Velicer WF. The Transtheoretical Model of health behavior change. Am J Health Promot. 1997;12:38–48.PubMedCrossRef
23.
Zurück zum Zitat Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47:1102–14.PubMedCrossRef Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol. 1992;47:1102–14.PubMedCrossRef
24.
Zurück zum Zitat Coleman MT, Pasternak RH. Effective strategies for behavior change. Prim Care. 2012;39:281–305.PubMedCrossRef Coleman MT, Pasternak RH. Effective strategies for behavior change. Prim Care. 2012;39:281–305.PubMedCrossRef
25.
Zurück zum Zitat Sobell LC, Sobell MB. Motivational interviewing strategies and techniques: rationales and examples. In: Nova Publishers Inc.; 2008. Sobell LC, Sobell MB. Motivational interviewing strategies and techniques: rationales and examples. In: Nova Publishers Inc.; 2008.
26.
Zurück zum Zitat Britt E, Hudson SM, Blampied NM. Motivational interviewing in health settings: a review. Patient Educ Couns. 2004;53:147–55.PubMedCrossRef Britt E, Hudson SM, Blampied NM. Motivational interviewing in health settings: a review. Patient Educ Couns. 2004;53:147–55.PubMedCrossRef
27.
Zurück zum Zitat Miller WR. Motivational interviewing: research, practice, and puzzles. Addict Behav. 1996;21:835–42.PubMedCrossRef Miller WR. Motivational interviewing: research, practice, and puzzles. Addict Behav. 1996;21:835–42.PubMedCrossRef
28.
Zurück zum Zitat American Academy of Pediatrics. Family-centered care and the pediatrician’s role. Pediatrics. 2003;112:691–7.CrossRef American Academy of Pediatrics. Family-centered care and the pediatrician’s role. Pediatrics. 2003;112:691–7.CrossRef
29.
Zurück zum Zitat Roter D. The enduring and evolving nature of the patient-physician relationship. Patient Educ Couns. 2000;39:5–15.PubMedCrossRef Roter D. The enduring and evolving nature of the patient-physician relationship. Patient Educ Couns. 2000;39:5–15.PubMedCrossRef
30.
Zurück zum Zitat van der Kruk JJ, Kortekaas F, Lucas C, Jager-Wittenaar H. Obesity: a systematic review on parental involvement in long-term European childhood weight control interventions with a nutritional focus. Obes Rev. 2013 Jun 4. doi: 10.1111/obr.12046. [Epub ahead of print]. van der Kruk JJ, Kortekaas F, Lucas C, Jager-Wittenaar H. Obesity: a systematic review on parental involvement in long-term European childhood weight control interventions with a nutritional focus. Obes Rev. 2013 Jun 4. doi: 10.​1111/​obr.​12046. [Epub ahead of print].
31.
Zurück zum Zitat • Faith MS, Van Horn L, Appel LJ, et al. Evaluating parents and adult caregivers as “agents of change” for treating obese children: evidence for parent behavior change strategies and research gaps: a scientific statement from the American Heart Association. Circulation. 2012;125:1186–207. This article provides an up-to-date review of the evidence supporting the importance of parents in helping children and adolescents in managing pediatric obesity. PubMedCrossRef • Faith MS, Van Horn L, Appel LJ, et al. Evaluating parents and adult caregivers as “agents of change” for treating obese children: evidence for parent behavior change strategies and research gaps: a scientific statement from the American Heart Association. Circulation. 2012;125:1186–207. This article provides an up-to-date review of the evidence supporting the importance of parents in helping children and adolescents in managing pediatric obesity. PubMedCrossRef
32.
Zurück zum Zitat • Skelton JA, Buehler C, Irby MB, Grzywacz JG. Where are family theories in family-based obesity treatment? Conceptualizing the study of families in pediatric weight management. Int J Obes. 2012;36:891–900. This article provides a strong argument for using theory-based interventions for managing pediatric obesity and the importance of advancing behavior change theories to examine and understand to role of lifestyle and behavior change in the family unit. CrossRef • Skelton JA, Buehler C, Irby MB, Grzywacz JG. Where are family theories in family-based obesity treatment? Conceptualizing the study of families in pediatric weight management. Int J Obes. 2012;36:891–900. This article provides a strong argument for using theory-based interventions for managing pediatric obesity and the importance of advancing behavior change theories to examine and understand to role of lifestyle and behavior change in the family unit. CrossRef
33.
Zurück zum Zitat Taylor A, Wilson C, Slater A, Mohr P. Parent and child-reported parenting. Associations with child weight related outcomes. Appetite. 2011;57:700–6.PubMedCrossRef Taylor A, Wilson C, Slater A, Mohr P. Parent and child-reported parenting. Associations with child weight related outcomes. Appetite. 2011;57:700–6.PubMedCrossRef
34.
Zurück zum Zitat La Greca AM, Mackay ER. Adherence to pediatric treatment regimens. In: Roberts MC, Steel RG, editors. Handbook of pediatric psychology. 4th ed. New York: Guilford Press; 2009. La Greca AM, Mackay ER. Adherence to pediatric treatment regimens. In: Roberts MC, Steel RG, editors. Handbook of pediatric psychology. 4th ed. New York: Guilford Press; 2009.
35.
Zurück zum Zitat Jakubowski KP, Black JJ, El Nokali NE, et al. Parents’ readiness to change affects BMI reduction outcomes in adolescents with polycystic ovary syndrome. J Obes. 2012;2012:298067.PubMedCrossRef Jakubowski KP, Black JJ, El Nokali NE, et al. Parents’ readiness to change affects BMI reduction outcomes in adolescents with polycystic ovary syndrome. J Obes. 2012;2012:298067.PubMedCrossRef
36.
Zurück zum Zitat Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360:473–82.PubMedCrossRef Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360:473–82.PubMedCrossRef
37.
Zurück zum Zitat La Greca AM. It’s “all in the family”: responsibility for diabetes care. J Pediatr Endocrinol Metabol. 1998;11:379–85. La Greca AM. It’s “all in the family”: responsibility for diabetes care. J Pediatr Endocrinol Metabol. 1998;11:379–85.
38.
Zurück zum Zitat Boutelle KN, Feldman S, Neumark-Sztainer D. Parenting an overweight or obese teen: issues and advice from parents. J Nutr Educ Behav. 2012;44:500–6.PubMedCrossRef Boutelle KN, Feldman S, Neumark-Sztainer D. Parenting an overweight or obese teen: issues and advice from parents. J Nutr Educ Behav. 2012;44:500–6.PubMedCrossRef
39.
Zurück zum Zitat Libbey HP, Story MT, Neumark-Sztainer DR, Boutelle KN. Teasing, disordered eating behaviors, and psychological morbidities among overweight adolescents. Obesity. 2008;16 Suppl 2:S24–9.PubMedCrossRef Libbey HP, Story MT, Neumark-Sztainer DR, Boutelle KN. Teasing, disordered eating behaviors, and psychological morbidities among overweight adolescents. Obesity. 2008;16 Suppl 2:S24–9.PubMedCrossRef
40.
Zurück zum Zitat Treasure J, Smith G, Crane A. Skills-based learning for caring for a loved one with an eating disorder. The new Maudsley method. Sussex: Routledge; 2007. Treasure J, Smith G, Crane A. Skills-based learning for caring for a loved one with an eating disorder. The new Maudsley method. Sussex: Routledge; 2007.
41.
Zurück zum Zitat Brug J, Conner M, Harre N, et al. The Transtheoretical Model and stages of change: a critique. Observations by five commentators on the paper by Adams, J. and White, M. (2004). Why don’t stage-based activity promotion interventions work? Health Educ Res. 2005;20:244–58.PubMedCrossRef Brug J, Conner M, Harre N, et al. The Transtheoretical Model and stages of change: a critique. Observations by five commentators on the paper by Adams, J. and White, M. (2004). Why don’t stage-based activity promotion interventions work? Health Educ Res. 2005;20:244–58.PubMedCrossRef
42.
Zurück zum Zitat • Tuah NA, Amiel C, Qureshi S, et al. Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev. 2011;10, CD008066. This article summarizes the evidence in applying the Transtheoretical model (TTM) to obesity management interventions in adults. Although the evidence supporting TTM-based interventions for reducing obesity is modest, the bigger impact of TTM-based interventions is on improving lifestyle behaviors (diet and physical activity). PubMed • Tuah NA, Amiel C, Qureshi S, et al. Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev. 2011;10, CD008066. This article summarizes the evidence in applying the Transtheoretical model (TTM) to obesity management interventions in adults. Although the evidence supporting TTM-based interventions for reducing obesity is modest, the bigger impact of TTM-based interventions is on improving lifestyle behaviors (diet and physical activity). PubMed
43.
Zurück zum Zitat Crabtree VM, Moore JB, Jacks DE, et al. A transtheoretical, case management approach to the treatment of pediatric obesity. J Prim Care Commun Health. 2010;1:4–7.CrossRef Crabtree VM, Moore JB, Jacks DE, et al. A transtheoretical, case management approach to the treatment of pediatric obesity. J Prim Care Commun Health. 2010;1:4–7.CrossRef
44.
Zurück zum Zitat Gale J. The Health Coaching Australia (HCA) model: an integrated model of health behaviour change for chronic disease prevention and chronic condition self-management. In: Health Coaching Guide for Health Practitioners: Using the HCA model of Health Coaching. New South Wales: Health Coaching Australia; 2010. Gale J. The Health Coaching Australia (HCA) model: an integrated model of health behaviour change for chronic disease prevention and chronic condition self-management. In: Health Coaching Guide for Health Practitioners: Using the HCA model of Health Coaching. New South Wales: Health Coaching Australia; 2010.
Metadaten
Titel
Tailoring Health Services for Managing Pediatric Obesity: A Proposed, Practice-Based Framework for Working with Families
verfasst von
Rachel A. Keaschuk
Geoff D. C. Ball
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Current Nutrition Reports / Ausgabe 4/2013
Elektronische ISSN: 2161-3311
DOI
https://doi.org/10.1007/s13668-013-0055-1

Weitere Artikel der Ausgabe 4/2013

Current Nutrition Reports 4/2013 Zur Ausgabe

Public Health and Translational Medicine (PW Franks, Section Editor)

Maternal Nutrition and Epigenetics in Early Life

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.