Pediatric Obesity Management in Rural Clinics in California and the Role of Telehealth in Distance Education


  • Preliminary data from this study were presented at the 2008 AcademyHealth Annual Child Health Services Research Meeting, Washington, DC. The authors thank Dr. Daniel Tancredi for guidance with statistical analysis and Hassan Baxi for assistance with data management. Ulfat Shaikh's work on this study was supported by career development awards from the University of California Davis Clinical and Translational Science Center (UL1 RR024146, National Center for Research Resources, National Institutes of Health), and the Agency for Healthcare Research and Quality (K08HS18567).

  • For further information, contact: Ulfat Shaikh, MD, MPH, MS, Department of Pediatrics, University of California Davis School of Medicine, 2516 Stockton Blvd., Room 335, Sacramento, CA 95817; e-mail


Objective: To determine health care provider needs related to pediatric obesity management in rural California and to explore strategies to improve care through telehealth.

Methods: Cross-sectional survey of health care providers who treated children and adolescents at 41 rural clinics with existing telehealth connectivity.

Results: Most of the 135 respondents were family physicians at designated rural health clinics serving low-income families. Respondents had practiced in rural areas for an average of 10 years. Most providers rated their self-efficacy in managing pediatric obesity as 2 or 3 on a 5-point scale. The barriers most frequently reported by health care providers were lack of local weight management programs, lack of patient motivation, and lack of family involvement in treatment. Providers reported that the resources they would find most helpful were readily accessible patient education materials, strategies to link patients with community treatment programs and training in brief, focused counseling skills. Three-quarters of providers already used telehealth for distance learning. Providers reported very high interest in participating in continuing education on pediatric obesity delivered by telehealth, specifically Internet communication with specialists, web-based education, and interactive video case-conferencing.

Conclusions: Rural health care providers face several barriers related to pediatric obesity management. Targeted interventions provided via telehealth to rural health care providers may enhance the care of obese children and adolescents. The results of this study provide directions and priorities for the design of appropriate interventions.