A Preschool Obesity Treatment Clinical Trial: Reasons Primary Care Providers Declined Referrals
In “A Preschool Obesity Treatment Clinical Trial: Reasons Primary Care Providers Declined Referrals” researchers led by Dr. Shannon M. Robson sought to identify reasons why primary care providers would not refer preschool patients with obesity to a weight management intervention. Researchers specifically looked at referral habits regarding children between the ages of 2 and 5 with a BMI greater than or equal to the 95th percentile. Reasons why doctors declined referrals for these children were recorded and analyzed by three experts. A card-sorting technique was used to sort and categorize doctors’ rationales, and resulted in the following categories:
Family not a fit, nonspecific
- Doctor does not believe weight is a problem
- Doctor thinks family would not be interested in treatment
- Doctor cites specific exclusion criteria
- Doctor does not believe BMI measurement is accurate
- Doctor has not previously discussed the child’s weight with their family
- Doctor does not want to offend family
- Doctor is uncomfortable referring patient
- Doctor does not believe the child needs treatment
- Doctor feels that referral would cause stress for the family
- Doctor feels that the parent’s profession would make the invitation inappropriate
Overall, the results indicate that primary care physicians will refer the majority of eligible preschoolers to a weight management program. In this study, doctors invited 78% of eligible families. The availability of a treatment program alone did not eliminate all barriers for referral.
Publication Information
Robson SM, Bolling C, McCullough MB, et al. A Preschool Obesity Treatment Clinical Trial: Reasons Primary Care Providers Declined Referrals. J Pediatr. 2016 Oct;177:262-266.e1.
