Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Leslie Scott

Clinical Mentor

Dr. Morgan Chojnacki

Committee Member

Dr. Mollie Aleshire


Background: Childhood and adolescent obesity rates have more than tripled since the 1970s. Currently in the United States, one in five children is obese (6-19 years of age). It is important to identify children and adolescents who are overweight or obese because early intervention may help to reduce the long-term implications of obesity. The purpose of this project was to examine how often pediatric primary care providers diagnosed overweight or obesity and created a plan of care for children 6-17 years of age who were overweight or obese. Facilitators and barriers to diagnosing and creating a plan of care were also examined.

Methods: This study consisted of a retrospective chart audit of patient data and an online survey with the primary care providers in the clinic.

Results: Children who were overweight had a weight-based diagnosis in their assessment 17.4% of the time, a plan of care developed 13% of the time, and a referral made to a pediatric subspecialist 2.2% of the time. Children who were obese had a weight-based diagnosis in their assessment 69.1% percent of the time, a plan of care 67.0% percent of the time, and a referral made to a pediatric subspecialist 27.7% of the time. The differences in assessment, plan of care, and referral rate between those who were overweight versus obese were statistically significant. There were no statistically significant differences between age groups.

Conclusion: Providers appropriately identified obesity and developed a plan of care 67% of the time. Overweight children were much less likely to be identified. It is important for clinicians to continue to improve on the rate at which they identify children who are either obese or overweight. Once identified, an effective plan of care addressing the child’s elevated body-mass index (BMI) needs to be developed. Ideally, the plan of care would include referral to a multidisciplinary center that has a team of providers working to fulfill the families’ goals over greater than 25 contact hours within the context of a patient-centered medical home.