{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T11:55:53Z","timestamp":1781351753249,"version":"3.54.1"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T00:00:00Z","timestamp":1535414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Childhood Obesity"],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The Texas Childhood Obesity Research Demonstration project, a multicenter, multisystem approach to childhood overweight and obesity (OW\/OB), included training and materials to support primary care clinics (PCCs) in addressing child OW\/OB in the office. This study evaluated the impact over 24 months of brief training and practice-based support on primary care providers' (PCPs) perceived self-efficacy and practice behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The PCPs at five Houston and seven Austin PCCs completed questionnaires at baseline (2012,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200936), 12 months (2013,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200930), and 24 months (2014,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200934) follow-up. Mixed-effects linear regression models were used to compare changes in self-efficacy (15 items, responses 1\u20134: not at all confident to very confident) and practice behaviors (30 items, responses 0\u20134: never to always) in obesity-related screening and counseling, and to assess association between prior training and these outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Self-efficacy items for identification of (2.9 [0.1] vs. 3.3 [0.1]) and counseling about (2.8 [0.1] vs. 3.4 [0.1]) OW\/OB-related parenting practices, and setting behavioral goals (2.9 [0.2] vs. 3.3 [0.2]) improved significantly (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) between baseline and 24-month follow-up. Self-efficacy items with \u201cconfident\u201d mean baseline scores that further improved included determining child OW\/OB (3.6 [0.1] vs. 3.9 [0.1]) and interpreting BMI (3.6 [0.1] vs. 3.9 [0.1]). At all measurements, PCPs reported frequently addressing medical problems and lifestyle behaviors. Use of patient-centered counseling techniques, which was low at baseline, increased significantly, including asking permission before discussing lifestyle (1.5 [0.3] vs. 2.4 [0.3]). Prior training was associated with improved self-efficacy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The improvement in PCPs' self-efficacy and patient-centered counseling to address childhood OW\/OB supports implementation of brief training and practice support in clinics that serve Medicaid-eligible children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/chi.2018.0119","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T01:45:31Z","timestamp":1535593531000},"page":"518-527","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Improvement in Primary Care Provider Self-Efficacy and Use of Patient-Centered Counseling To Address Child Overweight and Obesity after Practice-Based Changes: Texas Childhood Obesity Research Demonstration Study"],"prefix":"10.1177","volume":"14","author":[{"given":"Sarah E.","family":"Barlow","sequence":"first","affiliation":[{"name":"Texas Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meliha","family":"Salahuddin","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston (UTHealth)"},{"name":"Population Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy F.","family":"Butte","sequence":"additional","affiliation":[{"name":"USDA\/ARS Children's Nutrition Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna M.","family":"Hoelscher","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston (UTHealth)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Pont","sequence":"additional","affiliation":[{"name":"University of Texas at Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,8,28]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"1","article-title":"Prevalence of obesity among adults and youth: United States, 2015\u20132016","volume":"288","author":"Hales CM","year":"2017","unstructured":"Hales CM, , Carroll MD, , Fryar CD, , Ogden CL. Prevalence of obesity among adults and youth: United States, 2015\u20132016. NCHS Data Brief, 2017; 288:1\u20138.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/000992280304200307"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.S1.210"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2014.0057"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.07.025"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1177\/0009922814553432","article-title":"Brief training in patient-centered counseling for healthy weight management increases counseling self-efficacy and goal setting among pediatric primary care providers: Results of a pilot program","volume":"54","author":"Welsh JA","year":"2015","unstructured":"Welsh JA, , Nelson JM, , Walsh S, et al. 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