RESUMEN
CONTEXT: The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management. PURPOSE: This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol. The study also documented the prevalence of obesity-associated physiological and behavioral risk factors among overweight adolescent patients. METHODS: Ten rural clinics (58 providers) were recruited and received a 90-minute adolescent overweight assessment and management training session. Select biochemical, dietary, physical activity, and physical inactivity behaviors were assessed in overweight adolescent patients. Medical charts were abstracted to assess practitioner compliance with an overweight assessment protocol and patient adherence to a 16-week follow-up visit. FINDINGS: Providers were receptive to training and complied with the recommended protocol. Eighty-five overweight adolescents were assessed, but only 49 (57%) completed the scheduled 16-week follow-up visit. Physical, biochemical, and behavioral assessments revealed that 13%-27% of the participants had abnormal levels of lipids, fasting glucose, and glucose/insulin ratio, and 80.5% had waist circumferences above the 90th percentile. CONCLUSIONS: Practitioners complied with the assessment and follow-up protocol, leading to the discovery of previously unrecognized risk factors in many overweight adolescent patients. Lack of patient adherence to follow-up was the greatest limiting factor for obesity management. Further efforts are needed to implement and evaluate training to improve the management of adolescent overweight, especially in rural communities.
Asunto(s)
Personal de Salud/educación , Sobrepeso/prevención & control , Población Rural , Adolescente , Antropometría , Presión Sanguínea , Femenino , Georgia , Conductas Relacionadas con la Salud , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud/métodos , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
This study evaluated the effectiveness of an innovative, classroom-based physical activity prevention program designed to integrate academic curriculum elements along with a physical activity program in providing moderate-to-vigorous intensity physical activity. A convenience sample of three public school classrooms (one first, third, and fifth grade class) was observed implementing the TAKE 10! program while monitored by either CSA accelerometers or digital pedometers. Pedometer step counts and CSA data were recorded for each student and activity. As calculated from CSA data, average MET levels during the activities were 5.72-7.05 (first grade), 5.51-6.77 (third grade), and 4.98-7.19 (fifth grade), and levels were not different between grades (p > 0.05). Average caloric expenditure (Kcal) per 10-minute session was 25.6-27.8 (first grade), 27.6-33.9 (third grade), and 29.7-42.9 (fifth grade). Measured pedometer step counts per session ranged from 644-931 in first grade, 659-1, 376 in third grade, and 1002-1041 in fifth grade. TAKE 10! sessions for all three grades produced exercise levels in the moderate intensity range throughout full duration of the session. Classroom-based physical activity promotion provides a useful strategy to promote meaningful physical activity among school children.