Scaling-Up Stage 4 Pediatric Obesity Clinics: Identifying Barriers and Future Directions Using Implementation Science

Obesity (Silver Spring). 2021 Jun;29(6):941-943. doi: 10.1002/oby.23162. Epub 2021 Apr 26.

Abstract

Nearly one-fifth of the pediatric population in the United States has obesity. Comprehensive behavioral interventions, with at least 26 contact hours, are the recommended treatment for pediatric obesity; however, there are various barriers to implementing treatment. This Perspective applies the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to address barriers to implementing multidisciplinary pediatric weight management clinics and identify potential solutions and areas for additional research. Lack of insurance coverage and reimbursement, high operating costs, and limited access to stage 4 care clinics with sufficient capacity were among the main barriers identified. Clinicians, researchers, and patient advocates are encouraged to facilitate conversations with insurance companies and hospital and clinic administrators, increase telehealth adoption, request training to improve competency and self-efficacy discussing and implementing obesity care, and advocate for more stage 4 clinics.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Ambulatory Care Facilities / organization & administration
  • Ambulatory Care Facilities / standards
  • Ambulatory Care Facilities / supply & distribution*
  • Ambulatory Care Facilities / trends
  • Child
  • Child, Preschool
  • Delivery of Health Care, Integrated / organization & administration
  • Delivery of Health Care, Integrated / standards
  • Delivery of Health Care, Integrated / trends
  • Health Plan Implementation / methods
  • Health Plan Implementation / organization & administration
  • Health Plan Implementation / standards
  • Health Services Accessibility / organization & administration*
  • Health Services Accessibility / standards
  • Health Services Accessibility / trends
  • Humans
  • Implementation Science
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / therapy*
  • Research Design
  • Telemedicine
  • United States / epidemiology