Expanding the role of primary care in the prevention and treatment of childhood obesity: A review of clinic- and community-based recommendations and interventions

While pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand their primary care role. In 2012 the Institute of Medicine released recommendations for the prevention and treatment of obesity that expand and better integrate the health care provider's role into the community. We reviewed literature published between 2005 and 2012 to: (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings, and (2) synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting (e.g., capacity building, improvements in clinical practices) and through linkages to obesity prevention and treatment resources in the community. By aligning the most promising interventions with recommendations published over the last decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which primary care providers can promote the prevention and treatment of childhood obesity through efforts in both the clinical and community setting: weight status assessment and monitoring, healthy lifestyle promotion, patient counseling and treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multi-sector community initiatives, and policy advocacy.