Introduction
In 2007 and 2010, Expert Committee and U.S. Preventive Services Task Force guidelines
were released, respectively, urging U.S. practitioners to deliver preventive obesity
counseling for children. This study determined the frequency and evaluated predictors
of receiving counseling for diet and physical activity among a national sample of
children from 2002 to 2011.
Methods
Children aged 6–17 years were used from the 2002–2011 Medical Expenditure Panel Surveys
and analyzed in 2016. Parental report of two questions assessed whether children received
both dietary and exercise counseling from the provider. Children were grouped by weight
category. Bivariate analyses compared the frequency of receiving counseling; logistic
regression evaluated predictors of receiving counseling.
Results
The sample included 36,114 children; <50% of children received counseling. Across
all time periods, children were more likely to receive counseling with increasing
weight. Logistic regression models showed that obese children had greater odds of
receiving counseling versus normal-weight children, even after adjusting for covariates.
Additional significant positive correlates of receiving counseling were Hispanic ethnicity,
living in an urban setting, and being in the highest income stratum. Being uninsured
was associated with lower odds of counseling. Years 2007–2009 and 2010–2011 were associated
with increased counseling versus the benchmark year category in the multivariable
model.
Conclusions
Counseling appears more likely with greater weight and increased after both guidelines
in 2007 and 2010. Overall counseling rates for children remain low. Future work should
focus on marginalized groups, such as racial and ethnic minorities and rural populations.
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Article info
Publication history
Published online: March 29, 2017
Identification
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© 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
