Date of Graduation

Spring 2009


Master of Science in Nursing



Committee Chair

Susan-Sims Giddens


childhood obesity, television, diet, physical activity, treatment

Subject Categories



Childhood obesity is an epidemic that costs the United States (US) approximately fourteen billion dollars annually in medical expenses. Data collected by the National Health and Nutrition Examination Survey found that "17.1% of [US] children and adolescents were overweight…" (Ogden et al., 2006, p. 1549). Key research questions of the study were: (a) What is the overweight or obesity prevalence among children seen in one pediatric clinic in Southwest Missouri? (b) Which American Academy of Pediatrics (AAP) guidelines do pediatric practitioners follow when identifying, evaluating, and managing children who are overweight or obese? (c) Are there variations among the six physicians included in this study in adherence to AAP guidelines? (d) Does clinician experience (i.e. years in practice) or patient age, gender, or degree of obesity correlate with the practitioners adherence to AAP recommendations? A retrospective chart review was conducted on 524 charts, with 180 meeting selection criteria, for this descriptive correlational study. Selection criteria were children ages 3-18 with a body-mass-index (BMI) of 85% or greater. Six physicians from one Midwestern pediatric primary care clinic served as subjects for review. This study found a 34% (n=178) prevalence rate of a BMI 85% or more. The six subjects of this study (a) included dietary history [78%], physical activity history [33%], and sedentary lifestyle history [1%], (b) noted overweight or obesity [25%], (c) counseled on diet [76%], exercise [65%], sedentary behaviors [12%], (d) referred patients to a nutritionist and/or specialty [2%], (e) ordered laboratory evaluation [11%], and (f) advised close follow-up [6%]. Variations among the six physicians in adherence to AAP guidelines were found. Correlations were noted between age, BMI and provider level of experience and adherence to AAP guidelines.


© Tiffany LeAnn Villarreal

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