REPRINT OF: The Behavioral Risk Factor Surveys: I. State-Specific Prevalence Estimates of Behavioral Risk Factors.

Editor's Note: This article is a reprint of a previously published article. For citation purposes, please use the original publication details: Marks JS, Hogelin GC, Gentry EM, et al. The Behavioral Risk Factor Surveys: I.

Get healthy together: a program to improve counseling for childhood obesity in community-based WIC clinics.

Counseling parents of overweight children is a sensitive issue that has been reported to be difficult for many health professionals. The Get Healthy Together (GHT) project involved an 18-month intervention that provided skills training and new tools to Women, Infants, and Children (WIC) program staff and a staff wellness program to improve the physical self-concept and functioning of WIC employees. All WIC staff from the 48 WIC clinics in New Mexico participated in this study.

Innovative tools help counselors discuss childhood obesity with parents.

Background: Childhood overweight and obesity pose potential health risks for many children under the age of 5 years. Women, Infants, and Children (WIC) nutritionists are in a unique position to help reduce this problem because of their frequent counseling contacts with clients during certification visits. Therefore, four new tools to facilitate nutritional counseling of parents of overweight children during certifications were developed and systematically evaluated.

Motivational interviewing skills are positively associated with nutritionist self-efficacy.

Objective: To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy.

Design: Cross-sectional survey.

Setting: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics.

Training health care professionals to manage overweight adolescents: experience in rural Georgia communities.

Context: The obesity epidemic threatens the present and future health of adolescents in the United States. Yet, health care providers lack specific training for pediatric obesity assessment and management.

Purpose: This study examined the adherence of rural Georgia primary care practitioners to an overweight adolescent management protocol.

Improving providers' assessment and management of childhood overweight: results of an intervention.

Objective: Pediatric primary care providers' adherence to recommendations for the assessment and management of childhood overweight is low. There are scarce data addressing how to improve provider practices. This study evaluated the effect of provider training and office-based tool dissemination on pediatric providers' assessment and management of childhood overweight.

Prevalence and degree of childhood and adolescent overweight in rural, urban, and suburban Georgia.

The prevalence and severity of child and adolescent overweight (OW) in the United States have been documented, but little is known regarding the prevalence of OW and "Extent of Overweight" (EOW) in individual states or specific regions within states. The aim of this study was to determine the prevalence of OW and EOW in school-aged youths from 4 regions of Georgia. A 2-stage cluster sampling procedure was performed in 2002, with participation of 4th-, 8th- and 11th-grade students (N = 3114).

Evaluation of a training to improve management of pediatric overweight.

Introduction: Despite widespread concern about pediatric obesity, health care professionals report low proficiency for identifying and treating this condition. This paper reports on the evaluation of pediatric overweight assessment and management training for clinicians and staff in a managed care system. The training was evaluated for its impact on assessment practices and utilization of management tools.

Design and implementation of training to improve management of pediatric overweight.

Introduction: Clinicians report a low proficiency in treating overweight children and using behavioral management strategies. This paper documents the design and implementation of a training program to improve clinicians' skills in the assessment and behavioral management of pediatric overweight.

Methods: Two one-hour CME trainings were designed using published guidelines, research findings, and expert committee recommendations.

Childhood obesity: future directions and research priorities.

The threat of obesity is greater than ever for US children and adolescents. All indications are that the current generation of children will grow into the most obese generation of adults in US history. Furthermore, there is every expectation that the next generation of children is likely to be fatter and less fit than the current generation.

Treatment of child and adolescent obesity: reports from pediatricians, pediatric nurse practitioners, and registered dietitians.

Objective: The primary aim of this study was to identify interventions used by pediatric health care providers in treatment of overweight children and adolescents to identify provider educational needs. A secondary aim was to examine the association of certain provider characteristics with recommended evaluation practices.

Study Design: A random sample of pediatricians, pediatric nurse practitioners, and registered dietitians (RDs) received questionnaires about their diet, activity, and medication recommendations for overweight patients and about referrals to specialists and programs.

Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians.

Objective: The primary aim of this study was to determine how pediatric health care providers identify overweight in children and adolescents and how they evaluate obesity-related medical complications. This information can guide development of programs to help providers improve their evaluation practices. A secondary objective was to examine the association of certain provider characteristics with recommended evaluation practices.

Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals.

Objective: The primary aim of this study was to evaluate among health care professionals their attitudes, perceived barriers, perceived skill level, and training needs in the management of child and adolescent obesity.

Methods: A national needs assessment consisting of a mailed questionnaire was conducted among a random sample of health care professionals. The survey was completed by 202 pediatricians, 293 pediatric nurse practitioners, and 444 registered dietitians.

Management of child and adolescent obesity: study design and practitioner characteristics.

Objective: A study was undertaken to examine the attitudes and practices of health care providers in the assessment and treatment of overweight and obese children and adolescents. This study describes the study design and the practice settings and person characteristics of the practitioners included in this study.

Methods: A needs assessment questionnaire was developed by a working group consisting of researchers, clinicians, educators, and representatives of the Maternal and Child Health Bureau, Health Resources and Services Administration (Department of Health and Human Services), National Center for Education in Maternal and Child Health, International Life Sciences Institute, and Harris Interactive, Inc.

Prevention and control of iron deficiency: priorities and action steps.

The strengthening of global efforts to prevent and control iron deficiency requires priority setting and action steps in several key areas, including research, partnership formation, policy setting and the integration of intervention strategies. Research priorities include the development of improved assessment tools, evaluation of fortification strategies, improvement in interventions for infants, evaluation of combined intervention strategies to address multiple micronutrients and development and testing of interventions using genetically engineered foods with improved nutritional qualities. Policy priorities include the expansion of partnerships, balancing of advocacy, research and program implementation, and improved communications.

Summary and recommendations.

Iron deficiency affects the well being of > 1 billion people worldwide, with a range of adverse health and social consequences, yet efforts to address the problem have had only limited success. To better assess this issue and define more effective strategies, an international conference was convened in Atlanta, GA, in May 2001. Key policy issues discussed included setting a global goal for prevention and control of iron deficiency, building partnerships, and identifying ways to mobilize financial and human resources.

Improving trend of growth of Asian refugee children in the USA: Evidence to support the importance of environmental factors on growth.

In order to better define the trends and patterns of growth for children of Asian refugee families residing in the USA, we studied the anthropometric data from 12 states collected by the Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance System (PedNSS) from 1979 to 1993. The Asian refugee children under 5 years of age showed a progressive and significant decline in the prevalence of low height-for-age and low weight-for-age, while those nutritional indices remained stable for low income white children and black children. By 1993, the growth status of Asian refugee children was comparable with that of other ethnic groups.

Development of a research child growth reference and its comparison with the current international growth reference.

Objective: To better characterize childhood growth and further assess potential limitations of the current National Center for Health Statistics and World Health Organization international growth reference.

Design: The LMS method was used for curve fitting to summarize the changes in height and weight distributions by 3 curves representing the skewness (L), median (M), and coefficient of variation (S). A series of polynomial regression procedures was applied to smooth the L, M, and S curves.

Increasing prevalence of overweight among US low-income preschool children: the Centers for Disease Control and Prevention pediatric nutrition surveillance, 1983 to 1995.

Objective: To determine whether the prevalence of overweight in preschool children has increased among the US low-income population.

Design: Analysis using weight-for-height percentiles of surveillance data adjusted for age, sex, and race or ethnicity.

Setting: Data from 18 states and the District of Columbia were examined.

Issues in the assessment of nutritional status using anthropometry.

Four issues in the use and interpretation of anthropometry are discussed at the level of the population and of the individual. The first issue is the index or indices of choice: weight-for-height versus height-for-age versus weight-for-age. The selection of an index or indices depends upon many factors, and no one index is completely adequate in all situations.

Coordinated strategies for controlling micronutrient malnutrition: a technical workshop.

Participants in a November 1991 workshop concluded that coordinated strategies for controlling malnutrition due to iodine, iron, vitamin A and other micronutrients deficiencies are technically feasible and should be given consideration in planning control efforts. Coordinated surveys involving clinical, biochemical and dietary assessment of multiple micronutrients are feasible. Multiple fortification is also possible using such vehicles as salt, processed rice or sugar.

Trends and patterns in height and weight status of low-income U.S. children.

To better define the trends and patterns of growth for low-income children, we studied the anthropometry data collected by the second National Health and Nutrition Examination Survey (NHANES II) and the CDC Pediatric Nutrition Surveillance System (PNSS). Based on NHANES II, we found that low-income children appear to have a greater prevalence of shortness (low height-for-age), but do not have a greater prevalence of overweight (high weight-for-height) when compared with children from higher income families. Based on 12 states that were monitored continuously by the PNSS from 1980 to 1989, low-income children under 5 years of age appear to have a stable trend of height and weight status, with the exception of Asian children, most of whom were from Southeast Asian refugee background, showed a dramatic improvement in height status.