Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions

Introduction: Childhood obesity, with its growing prevalence, detrimental effects on population health and economic burden, is an important public health issue in the United States and worldwide. There is need for expansion of the role of primary care physicians in obesity interventions. The primary aim of this review is to explore primary care physician (PCP) mediated interventions targeting childhood obesity and assess the roles played by physicians in the interventions. Methods: A systematic review of the literature published between January 2007 and October 2014 was conducted using a combination of keywords like "childhood obesity'', "paediatric obesity'', "childhood overweight'', "paediatric overweight'', "primary care physician'', "primary care settings'', "healthcare teams'', and "community resources'' from MEDLINE and CINAHL during November 2014. Author name(s), publication year, sample size, patient's age, study and follow-up duration, intervention components, role of PCP, members of the healthcare team, and outcomes were extracted for this review. Results: Nine studies were included in the review. PCP-mediated interventions were composed of behavioural, education and technological interventions or a combination of these. Most interventions led to positive changes in Body Mass Index (BMI), healthier lifestyles and increased satisfaction among parents. PCPs participated in screening and diagnosing, making referrals for intervention, providing nutrition counselling, and promoting physical activity. PCPs, Dietitians and nurses were often part of the healthcare team. Conclusion: PCP-mediated interventions have the potential to effectively curb childhood obesity. However, there is a further need for training of PCPs, and explain new-types of interventions such as the use of technology. (C) 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.