402 - Parent and Clinician-Reported Challenges Related to Pediatric Weight Management during the COVID-19 Pandemic in a Low-Income Patient Population

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 402
Publication Number: 402.146

Jennifer G.. Fiore, Boston University School of Medicine, Medford, MA, United States; Meg Simione, Massachusetts General Hospital, Boston, MA, United States; Kelsey A. Egan, Boston University School of Medicine, Boston, MA, United States; Man Luo, MassGeneral Hospital for Children, Cambridge, MA, United States; elsie taveras, MassGeneral Hospital for Children, Boston, MA, United States; William G. Adams, Boston Medical Center/Boston University School of Medicine, Wayland, MA, United States; Caroline J. Kistin, Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, RI, United States

Presenting Author(s)

JF

Jennifer G. Fiore, MD (she/her/hers)

Assistant Professor of Pediatrics
Boston University School of Medicine
Medford, Massachusetts, United States

Background: In 2021, the Centers for Disease Control and Prevention reported a notable increase in childhood obesity during the COVID-19 pandemic.

Objective: With the aim of improving family-centered obesity treatment and prevention, we sought to understand parents’ and clinicians’ challenges and priorities related to weight management during the pandemic.

Design/Methods: Surveys were conducted in fall of 2021 with 150 parents and 25 clinicians from a large pediatric primary care clinic that serves a predominantly low-income, Black and Latino population. Parents were eligible if they spoke English or Spanish and had a child aged 2 to 12 years with body mass index (BMI) ³ 85th percentile. Clinicians were eligible if they provided primary care for children with overweight or obesity. Parent surveys included questions about household resources, child routines, and desired support. Clinicians were asked about clinical challenges, resources, and needs. Data were analyzed using descriptive statistics.

Results:

Parent characteristics are reported in Table 1; 49% identified as Black, and 37% as Latino. During the pandemic, 65% of families experienced food insecurity and 55% experienced housing insecurity. While 79% of families reported that they were asked about unmet needs in clinic, only 59% reported that they were connected to resources.

The pandemic moderately or severely impacted child routines in 63% of households. Compared to pre-pandemic, many parents reported that their child ate more (50%), was less active (59%), and spent less time outside (66%). When asked what resources would be most helpful in supporting child weight management, top responses included nutrition support (41%), structured in-person activity programs (32%), food stamps (27%), and outdoor play areas (25%).
Top clinician-reported challenges providing weight management care during the pandemic included lack of resources to address unmet household needs (76%), lack of nutrition resources (68%), and lack of outdoor spaces to recommend to families (64%). All clinicians felt it would be helpful to have additional information on available resources for families and guidance on how to tailor weight management based on unmet needs.

Conclusion(s): For low-income families of children with elevated BMIs, rates of food and housing insecurity during the pandemic were high. Parent priorities included accessing nutrition education, food resources, and safe outdoor spaces, but clinicians perceived challenges providing support in these areas and were interested in additional resources to improve care.