{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:51:48Z","timestamp":1792050708644,"version":"4.4.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"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":["Am J Health Promot"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>A Quality Improvement (QI) initiative was implemented to improve evidence-based pediatric obesity related clinical care. We evaluated changes in clinicians\u2019 knowledge and confidence and their perception of improvements and challenges in obesity-related clinical care post-QI implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>The study included pre and post-intervention self-report surveys, semi-structured qualitative interviews, and randomized chart reviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The setting was two primary care centers in Washington, DC between March 2021-March 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of the 42 clinicians offered multi-modal interventions, 33% completed both surveys. Of the 17 clinicians offered a qualitative interview, 15 were completed (88%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Quantitative analysis was conducted using McNemar\u2019s exact test and qualitative data underwent thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data analysis demonstrated an overall positive and significant change in clinician confidence in diagnosing and managing pediatric obesity (\n                      <jats:bold>\u03a7<\/jats:bold>\n                      <jats:sup>2<\/jats:sup>\n                      = 12.0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0005). The post-intervention thematic analysis of semi-structured clinician interviews identified three major themes: (1) improvement in clinical obesity management, (2) barriers to effective clinical obesity management, and (3) deeper self-reflection of obesity stigma on clinical weight management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While barriers exist in managing obesity within medical homes, the implementation of a targeted QI initiative may improve pediatric clinicians\u2019 confidence in providing evidence based culturally competent care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171261417441","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T20:41:36Z","timestamp":1768596096000},"page":"1008-1017","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Aligning Clinical Practice with Evidence: Primary Care Pediatricians\u2019 Perspectives on Standardizing Obesity Management"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7725-6405","authenticated-orcid":false,"given":"Nia Imani","family":"Bodrick","sequence":"first","affiliation":[{"name":"Department of General and Community Pediatrics, Children\u2019s National Hospital"},{"name":"Department of Pediatrics, The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of General and Community Pediatrics, Children\u2019s National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erynn","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of General and Community Pediatrics, Children\u2019s National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaleab","family":"Ribbiso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Nassau","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of General and Community Pediatrics, Children\u2019s National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Essel","sequence":"additional","affiliation":[{"name":"Department of General and Community Pediatrics, Children\u2019s National Hospital"},{"name":"Department of Pediatrics, The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of General and Community Pediatrics, Children\u2019s National Hospital"},{"name":"Department of Pediatrics, The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X19891305"},{"key":"e_1_3_8_3_2","first-page":"1","article-title":"National Health and nutrition examination survey 2017\u2013March 2020 prepandemic data files: development of files and prevalence estimates for selected health outcomes","volume":"158","author":"Stierman B","year":"2021","unstructured":"Stierman B, Afful J, Carroll MD, et al. National Health and nutrition examination survey 2017\u2013March 2020 prepandemic data files: development of files and prevalence estimates for selected health outcomes. Natl Health Stat Report. 2021;158:1-2.","journal-title":"Natl Health Stat Report"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2329E"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.11146"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-052162"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-0865"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.85"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060640"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-3034"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2025-004962"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2021.0274"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-2870-y"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedcp.2024.200135"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_8_16_2","volume-title":"Qualitative Research & Evaluation Methods: Integrating Theory and Practice","author":"Patton MQ","year":"2014","unstructured":"Patton MQ. Qualitative Research & Evaluation Methods: Integrating Theory and Practice. 4th ed. Thousand Oaks (CA): Sage Publications; 2014.","edition":"4"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2018.07.007"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/pq9.0000000000000412"},{"issue":"1","key":"e_1_3_8_19_2","first-page":"200","article-title":"A resident-led quality improvement project to improve obesity recognition and treatment within a pediatric continuity clinic","volume":"4","author":"Loftis P","year":"2019","unstructured":"Loftis P, Kiger M, Hammond C. A resident-led quality improvement project to improve obesity recognition and treatment within a pediatric continuity clinic. Pediatr Qual Saf. 2019;4(Suppl 1):200. (Note: Confirm journal name and issue if available.).","journal-title":"Pediatr Qual Saf"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60648-6"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001694"}],"container-title":["American Journal of Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08901171261417441","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08901171261417441","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08901171261417441","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:09:13Z","timestamp":1792048153000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08901171261417441"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/08901171261417441"],"URL":"https:\/\/doi.org\/10.1177\/08901171261417441","relation":{},"ISSN":["0890-1171","2168-6602"],"issn-type":[{"value":"0890-1171","type":"print"},{"value":"2168-6602","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}