Primary Care, Communication, and Improving Children's Health

We will test whether 1) pediatrician-patient communication regarding overweight status,
behavior/risk-factor counseling, and the frequency and time to next follow-up visit, compared
with either no communication or incomplete communication (communicating only high weight
status without behavior/risk-factor counseling or a follow-up visit) will predict improvement
in weight status at one year follow-up, and 2) during pediatrician-patient communication
regarding weight and weight management, higher patient-centeredness will predict improvement
in weight status at one year follow-up. The communication content identified will generate
new information about the most effective content and style of pediatrician-patient
communication that predict weight-status improvement. Because we prospectively will examine
clinical practice elements in the one-year interval between well-child visits, acknowledging
that communication regarding high weight status may initiate assessment of risk factors for
heart disease (such as high cholesterol and blood sugar), more frequent follow-up visits, or
prompt a nutrition referral, we will generate novel information about the most effective
clinical practices and follow-up interval and frequency that predict weight-status
improvement in overweight children. We also will examine if the content and style of
communication are related to improvements in diet and lifestyle behaviors at one-year
follow-up.

Inclusion Criteria:

- Schedule a well-child visit with a participating pediatrician

- Agree to return in one year for the follow-up well-child visit

- Overweight

- 6-12 years old

- Have a working telephone and/or e-mail address

- Child/parent willing to provide assent/consent

Exclusion Criteria:

- Unstable illness (such as uncontrolled asthma)

- Developmental condition (such as trisomy 21)

- Planning to move/leave practice within two years