Rapid Communication| Volume 51, ISSUE 1, P106-113, July 2016

Sensitizing Future Health Professionals to Determinants of Childhood Obesity

Published:February 11, 2016DOI:
      Long-term solutions to the childhood obesity epidemic will require concerted interdisciplinary efforts that are sensitive to both individual and social determinants of health. The Junior Doctors of Health© (JDOH) program involves interprofessional education (IPE) with university students from health science fields (e.g., medicine, pharmacy, social work, public health) who deliver an interactive program in teams to at-risk school-aged youth. The purpose of this study was to assess the impact of participation in the JDOH IPE program on university students’ beliefs about childhood obesity. Fifty-three of the 71 health sciences students enrolled in the JDOH IPE program between 2011 and 2013 participated in this study. Pre- and post-surveys assessed students’ beliefs about the importance, causes of, and responsibility for reducing childhood obesity with both closed- and open-ended questions. In 2013, quantitative data were analyzed using Wilcoxon matched-pairs signed-rank tests and qualitative data were analyzed through open coding to identify emergent themes. Results indicate that after participation in the JDOH IPE program, students’ identification of social and environmental causes of childhood obesity increased significantly. Further, students’ ranking of the importance of obesity was initially higher than those of different issues typically portrayed as social or environmental (e.g., youth violence) but it was similarly ranked after participation in JDOH. This suggests a greater sensitivity to social and environmental challenges faced by youth. Findings suggest that IPE experiences that bring clinical and community-oriented health professions together to engage with disadvantaged youth foster sensitivity to the complexities of childhood obesity in low-income settings.
      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 American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Centers for Disease Control and Prevention. Childhood obesity facts. Adolescent and school health. Published 2014. Accessed November 11, 2014.

        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • Flegal K.M.
        Prevalence of childhood and adult obesity in the United States, 2011-2012.
        JAMA. 2014; 311: 806
        • Ebbeling C.B.
        • Pawlak D.B.
        • Ludwig D.S.
        Childhood obesity: public-health crisis, common sense cure.
        Lancet. 2002; 360: 473-482
        • Dietz W.H.
        • Robinson T.N.
        Overweight children and adolescents.
        N Engl J Med. 2005; 352: 2100-2109
        • Dietz W.H.
        Health consequences of obesity in youth: Childhood predictors of adult disease.
        Pediatrics. 1998; 101: 518-525
        • Reilly J.J.
        Health consequences of obesity.
        Arch Dis Child. 2003; 88: 748-752
        • Barlow S.E.
        • Dietz W.H.
        Management of child and adolescent obesity: summary and recommendations based on reports from pediatricians, pediatric nurse practitioners, and registered dietitians.
        Pediatrics. 2002; 110: 236-238
        • 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
        • Chamberlin L.A.
        • Sherman S.N.
        • Jain A.
        • Powers S.W.
        • Whitaker R.C.
        The challenge of preventing and treating obesity in low-income, preschool children: Perceptions of WIC health care professionals.
        Arch Pediatr Adolesc Med. 2002; 156: 662
        • Mikhailovich K.
        • Morrison P.
        Discussing childhood overweight and obesity with parents: a health communication dilemma.
        J Child Health Care. 2007; 11: 311-322
        • Puhl R.M.
        • Heuer
        The stigma of obesity: a review and update.
        Obesity. 2009; 17: 941-964
        • Puhl R.
        • Brownell K.D.
        Confronting and coping with weight stigma: an investigation of overweight and obese adults.
        Obesity. 2006; 14: 1802-1815
        • Puhl R.
        • Brownell K.D.
        Bias, discrimination, and obesity.
        Obesity. 2001; 9: 788-805
        • Chambliss H.O.
        • Finley C.E.
        • Blair S.N.
        Attitudes toward obese individuals among exercise science students.
        Med Sci Sports Exerc. 2004; 36: 468-474
        • Oberrieder H.
        • Walker R.
        • Monroe D.
        • Adeyanju M.
        Attitude of dietetics students and registered dietitians toward obesity.
        J Am Diet Assoc. 1995; 95: 914-916
        • Wigton R.S.
        • McGaghie W.C.
        The effect of obesity on medical students’ approach to patients with abdominal pain.
        J Gen Intern Med. 2001; 16: 262-265
        • Puhl R.M.
        • Luedicke J.
        • Grilo C.M.
        Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines.
        Obesity. 2014; 22: 1008-1015
        • Wiese H.J.
        • Wilson J.F.
        • Jones R.A.
        • Neises M.
        Obesity stigma reduction in medical students.
        Int J Obes Relat Metab Disord. 1992; 16: 859-868
        • Ip E.H.
        • Marshall S.
        • Vitolins M.
        • et al.
        Measuring medical student attitudes and beliefs regarding patients who are obese.
        Acad Med. 2013; 88: 282-289
        • Wear D.
        • Aultman J.M.
        • Varley J.D.
        • Zarconi J.
        Making fun of patients: medical students’ perceptions and use of derogatory and cynical humor in clinical settings.
        Acad Med J Assoc Am Med Coll. 2006; 81: 454-462
        • Miller D.P.
        • Spangler J.G.
        • Vitolins M.Z.
        • et al.
        Are medical students aware of their anti-obesity bias?.
        Acad Med. 2013; 88: 978-982
        • Drury C.A.A.
        • Louis M.
        Exploring the association between body weight, stigma of obesity, and health care avoidance.
        J Am Acad Nurse Pract. 2002; 14: 554-561
        • Puhl R.M.
        • Peterson J.L.
        • Luedicke J.
        Parental perceptions of weight terminology that providers use with youth.
        Pediatrics. 2011; 128: e786-e793
        • Campbell K.
        • Engel H.
        • Timperio A.
        • Cooper C.
        • Crawford D.
        Obesity Management: Australian general practitioners’ attitudes and practices.
        Obesity. 2000; 8: 459-466
        • Epstein L.
        • Ogden J.
        A qualitative study of GPs’ views of treating obesity.
        Br J Gen Pract. 2005; 55: 750-754
        • Brown I.
        • Stride C.
        • Psarou A.
        • Brewins L.
        • Thompson J.
        Management of obesity in primary care: nurses’ practices, beliefs and attitudes.
        J Adv Nurs. 2007; 59: 329-341
        • 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
        • Jelalian E.
        • Boergers J.
        • Alday C.S.
        • Frank R.
        Survey of physician attitudes and practices related to pediatric obesity.
        Clin Pediatr (Phila). 2003; 42: 235-245
        • Perrin E.M.
        • Flower K.B.
        • Garrett J.
        • Ammerman A.S.
        Preventing and treating obesity: pediatricians’ self-efficacy, barriers, resources, and advocacy.
        Ambul Pediatr. 2005; 5: 150
        • Spencer E.H.
        • Frank E.
        • Elon L.K.
        • Hertzberg V.S.
        • Serdula M.K.
        • Galuska D.A.
        Predictors of nutrition counseling behaviors and attitudes in U.S. medical students.
        Am J Clin Nutr. 2006; 84: 655-662
        • Harvey E.L.
        • Summerbell C.D.
        • Kirk S.F.L.
        • Hill A.J.
        Dietitians’ views of overweight and obese people and reported management practices.
        J Hum Nutr Diet. 2002; 15: 331-347
        • Kushner R.F.
        • Zeiss D.M.
        • Feinglass J.M.
        • Yelen M.
        An obesity educational intervention for medical students addressing weight bias and communication skills using standardized patients.
        BMC Med Educ. 2014; 14: 53
        • Rosemond T.N.
        • Blake C.E.
        • Jenkins K.A.
        • Buff S.M.
        • Moore J.B.
        Dietary improvements among African American youth: results of an interactive nutrition promotion program.
        Am J Health Educ. 2015; 46: 40-47
        • Buff S.M.
        • Gibbs P.Y.
        • Oubré O.
        • Ariail J.C.
        • Blue A.V.
        • Greenberg R.S.
        Junior Doctors of Health©: an interprofessional service-learning project addressing childhood obesity and encouraging health care career choices.
        J Allied Health. 2011; 40: 39E-44E
        • Buff S.M.
        • Jenkins K.
        • Kern D.
        • et al.
        Interprofessional service-learning in a community setting: findings from a pilot study.
        J Interprof Care. 2015; 29: 159-161
        • Evans W.D.
        • Finkelstein E.A.
        • Kamerow D.B.
        • Renaud J.M.
        Public perceptions of childhood obesity.
        Am J Prev Med. 2005; 28: 26-32
        • McLeroy K.R.
        • Bibeau D.
        • Steckler A.
        • Glanz K.
        An ecological perspective on health promotion programs.
        Health Educ Q. 1988; 15: 351-377
        • Glaser B.G.
        • Strauss A.L.
        The Discovery of Grounded Theory: Strategies for Qualitative Research.
        Aldine Pub. Co, Chicago1967
        • Kumanyika S.K.
        • Grier S.
        Targeting interventions for ethnic minority and low-income populations.
        Future Child. 2006; 16: 187-207
        • Rew L.
        • Horner S.D.
        Youth resilience framework for reducing health-risk behaviors in adolescents.
        J Pediatr Nurs. 2003; 18: 379-388
        • Dowdell E.B.
        • Santucci M.E.
        The relationship between health risk behaviors and fear in one urban seventh grade class.
        J Pediatr Nurs. 2003; 18: 187-194
        • Caprio S.
        • Daniels S.R.
        • Drewnowski A.
        • et al.
        Influence of race, ethnicity, and culture on childhood obesity: implications for prevention and treatment: a consensus statement of Shaping America’s Health and the Obesity Society.
        Diabetes Care. 2008; 31: 2211-2221
        • McCaffrey R.
        • Tappen R.M.
        • Lichtstein D.M.
        • Friedland M.
        Interprofessional education in community-based Alzheimer’s disease diagnosis and treatment.
        J Interprof Care. 2013; 27: 534-536
        • Furze J.
        • Lohman H.
        • Mu K.
        Impact of an interprofessional community-based educational experience on students’ perceptions of other health professions and older adults.
        J Allied Health. 2008; 37: 71-77
        • Street K.N.
        • Eaton N.
        • Clarke B.
        • et al.
        Child disability case studies: an interprofessional learning opportunity for medical students and paediatric nursing students.
        Med Educ. 2007; 41: 771-780