Are Graduating Pediatric Residents Prepared to Engage in Obesity Prevention and Treatment?

Published:January 27, 2016DOI:



      Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice.


      A national, random sample of 1000 graduating pediatric residents were surveyed in 2013 on childhood overweight/obesity and preparedness to prevent and treat obesity. A composite training measure was created by summing the number of areas (10 possible) where training on overweight/obesity was received. Multivariable logistic regression explored relationships of resident and training characteristics to residents' belief that their own counseling on prevention and treatment of overweight/obesity is very effective (vs somewhat/slightly/not effective).


      Of 625 survey respondents (63% response), most (68–92%) reported receipt of training in each of 10 assessed areas on overweight/obesity prevention, assessment, and treatment. Most residents did not desire more training in the assessed areas; however, 54% wanted more training in motivational interviewing. About one-fourth believed that their own counseling on the prevention of overweight/obesity (26%) and treatment of obesity (22%) was very effective. Residents who rated their ability to use motivational interviewing as very good/excellent were more likely to rate their counseling on both the prevention and treatment of overweight/obesity as very effective (adjusted odds ratio [aOR] 4.33, 95% confidence interval [CI] 2.63–7.13; and aOR 4.69, 95% CI 2.72–8.07, respectively). Residents who received training in all 10 assessed areas were also more likely to rate their counseling on both prevention and treatment as very effective (aOR 2.58, 95% CI 1.61–4.14; aOR 2.41, 95% CI 1.46–3.97, respectively).


      Comprehensive training on overweight/obesity and inclusion of training in motivational interviewing may help residents feel better prepared to care for children with overweight/obesity.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • et al.
        Prevalence of childhood and adult obesity in the United States, 2011–2012.
        JAMA. 2014; 311: 806-814
        • Daniels S.R.
        • Hassink S.G.
        Committee on Nutrition. The role of the pediatrician in primary prevention of obesity.
        Pediatrics. 2015; 136: e275-e292
        • Barlow S.E.
        • Expert Committee
        Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.
        Pediatrics. 2007; 120: S164-S192
        • Davis M.M.
        • Gance-Cleveland B.
        • Hassink S.
        • et al.
        Recommendations for prevention of childhood obesity.
        Pediatrics. 2007; 120: S229-S253
        • Krebs N.F.
        • Himes J.H.
        • Jacobson D.
        • et al.
        Assessment of child and adolescent overweight and obesity.
        Pediatrics. 2007; 120: S193-S228
        • Spear B.A.
        • Barlow S.E.
        • Ervin C.
        • et al.
        Recommendations for treatment of child and adolescent overweight and obesity.
        Pediatrics. 2007; 120: S254-S288
        • Bean M.K.
        • Powell P.
        • Quinoy A.
        • et al.
        Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial.
        Pediatr Obes. 2015; 10: 118-125
        • Resnicow K.
        • Davis R.
        • Rollnick S.
        Motivational interviewing for pediatric obesity: conceptual issues and evidence review.
        J Am Diet Assoc. 2006; 106: 2024-2033
      1. Resnicow K, Bocian A, Harris D, et al. Can brief motivational interviewing in practice reduce child body mass index? Results of a 2-year randomized controlled trial. Paper presented at: Pediatric Academic Societies Meeting; 2014; Vancouver, Canada.

        • Schwartz R.P.
        • Hamre R.
        • Dietz W.H.
        • et al.
        Office-based motivational interviewing to prevent childhood obesity: a feasibility study.
        Arch Pediatr Adolesc Med. 2007; 161: 495-501
        • Klein J.D.
        • Sesselberg T.S.
        • Johnson M.S.
        • et al.
        Adoption of body mass index guidelines for screening and counseling in pediatric practice.
        Pediatrics. 2010; 125: 265-272
        • Jay M.
        • Gillespie C.
        • Ark T.
        • et al.
        Do internists, pediatricians, and psychiatrists feel competent in obesity care? Using a needs assessment to drive curriculum design.
        J Gen Intern Med. 2008; 23: 1066-1070
        • Wolff M.S.
        • Rhodes E.T.
        • Ludwig D.S.
        Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors.
        BMC Med Educ. 2010; 10: 18
        • Goff S.L.
        • Holmboe E.S.
        • Curry L.
        Barriers to obesity training for pediatric residents: a qualitative exploration of residency director perspectives.
        Teach Learn Med. 2006; 18: 348-355
        • Carcone A.I.
        • Naar-King S.
        • Brogan K.E.
        • et al.
        Provider communication behaviors that predict motivation to change in black adolescents with obesity.
        J Dev Behav Pediatr. 2013; 34: 599-608
        • Block J.P.
        • DeSalvo K.B.
        • Fisher W.P.
        Are physicians equipped to address the obesity epidemic? Knowledge and attitudes of internal medicine residents.
        Prev Med. 2003; 36: 669-675
        • Forman-Hoffman V.
        • Little A.
        • Wahls T.
        Barriers to obesity management: a pilot study of primary care clinicians.
        BMC Fam Pract. 2006; 7: 35
        • Krebs N.F.
        • Jacobson M.S.
        • American Academy of Pediatrics Committee on Nutrition
        Prevention of pediatric overweight and obesity.
        Pediatrics. 2003; 112: 424-430
        • Benson L.
        • Baer H.J.
        • Kaelber D.C.
        Trends in the diagnosis of overweight and obesity in children and adolescents: 1999–2007.
        Pediatrics. 2009; 123: e153-e158
        • Sesselberg T.S.
        • Klein J.D.
        • O'Connor K.G.
        • et al.
        Screening and counseling for childhood obesity: results from a national survey.
        J Am Board Fam Med. 2010; 23: 334-342
        • American Academy of Pediatrics
        Majority of pediatricians use body mass index to screen for obesity.
        AAP News. 2013; 34: 18
        • Story M.T.
        • Neumark-Stzainer D.R.
        • Sherwood N.E.
        • et al.
        Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals.
        Pediatrics. 2002; 110: 210-214
        • Perrin E.M.
        • Vann J.C.
        • Lazorick S.
        • et al.
        Bolstering confidence in obesity prevention and treatment counseling for resident and community pediatricians.
        Patient Educ Couns. 2008; 73: 179-185
        • Schumacher D.J.
        • Englander R.
        • Hicks P.J.
        • et al.
        Domain of competence: patient care.
        Acad Pediatr. 2014; 14: S13-S35
        • Accreditation Council for Graduate Medical Education
        ACGME program requirements for graduate medical education in pediatrics.
        2012 (Available at:) (Accessed December 17, 2015)
        • Roter D.
        The medical visit context of treatment decision-making and the therapeutic relationship.
        Health Expect. 2000; 3: 17-25
        • Cull W.L.
        • O'Connor K.G.
        • Sharp S.
        • et al.
        Response rates and response bias for 50 surveys of pediatricians.
        Health Serv Res. 2005; 40: 213-226