A comprehensive survey of US pediatric obesity programs

Background: The prevalence of overweight children in the US has tripled in the last three decades. In response, new childhood obesity programs have developed across the nation. Little is known about the structure, type of services, funding or future of these programs. Furthermore, lacking is network of similar programs that offer an avenue for support and sharing resources. To address these deficiencies, a database was developed to characterize existing pediatric obesity programs in major children's hospitals across the United States.

Methods: We conducted an internet survey of all member hospitals in the National Association of Children's Hospitals and Related Institutions (NACHRI). We used multiple internet, telephone, and email queries to identify the obesity programs and the program personnel at the each hospital. The survey focused on structure, demographics, services provided, funding, communication, challenges, and future of the programs.

Results: Of 181 Children's Hospital, 90 (50%) had an obesity program, 20 (11%) had no program, 49 (27%) offered only individualized dietary counseling, and 22 (12%) could not be contacted. Data collection is still on-going and will be completed by June 2007.

Preliminary results (30/90 programs) indicate two-thirds of programs had been operational for >3years. Adopting lifestyle changes (79%) was the most frequent program goal. Twenty-six percent of programs had a multidisciplinary team comprised of a physician, dietitian, physical activity specialist and psychologist. Only 23% and 19% of programs offered weight-loss medication and bariatric surgery, respectively. In addition to their medical program, 61% of the children's hospitals offered other diet and physical activity programs within the community. Parent participation was required by 92% of the programs. Eleven (40%) programs offered both individualized visits and group sessions. Program costs varied, ranging from $0 to $3400. Better reimbursement rates and additional grant funding were seen as the top challenges for the program's future. All of the programs would like better communication with other programs.

Conclusion: Our results help us understand the basic structure, resources and challenges for pediatric obesity programs. Creating a database of such information will be useful for developing new programs, improving our patient care, and connecting existing programs as the medical community responds to the obesity epidemic.