Childhood obesity is a disease that affects 17% of children aged 2-19. This disease, best described by a social ecological perspective, is multifactorial in nature and includes individual, familial, community, and societal contributors. As the causes are multifactorial, so too should be prevention and treatment. Healthcare providers, specifically physicians, can play an important role in the diagnosis, prevention, and treatment of childhood obesity, especially if they appropriately utilize nutrition behavior change counseling to facilitate lifestyle changes. Behavior change falls within the realm of the social and behavioral sciences, disciplines that will receive greater emphasis on the newly designed MCAT 2015®; therefore, premedical and medical programs may need to alter their approaches to disseminating this discipline-specific knowledge. Nutrition education is currently limited in medical education; and thus, just as premedical programs seek to increase the social and behavioral sciences, so too should they increase nutrition education. In light of these recommended curricular changes, researchers sought to investigate the current state of premedical and medical students. views of childhood obesity. This dissertation describes three studies conducted for that purpose. In study 1, researchers investigated 30 pre-healthcare undergraduate seniors. views of childhood obesity and their sources of knowledge through in-depth qualitative interviews. Investigators found that students with specialized coursework and significant volunteer and/or internship experience had a deeper understanding of childhood obesity; however, as a whole, students failed to see the role of healthcare providers in prevention and treatment. These findings provide justification for premedical programs to guide students to see their role in prevention and treatment through educating them on the social ecological model and providing them with relevant service-learning opportunities and guided reflection. In study 2, researchers conducted a similar nationwide qualitative investigation in 78 third and fourth year medical students. These students described student-, patient- and healthcare system-centered barriers, including their lack of knowledge, patients. lack of access, and their lack of time in practice. Students also requested more applicable information and counseling training in order to equip them to prevent and treat childhood obesity. Much like the pre-healthcare seniors, these medical students failed to discuss their role in prevention and treatment. Therefore, medical schools need to help their students overcome barriers by providing them knowledge and skills and helping them understand their role in prevention and treatment. In study 3, researchers built on the knowledge gained from study 1 and study 2 and developed a valid and reliable computerized tool, the Childhood Obesity Prevention Self-efficacy (COP-SE) survey. Factor analysis of 444 completed surveys from students at 53 medical schools revealed a two factor structure with a correlation of 0.637 between factors. Factor 1 assesses self-efficacy in nutrition counseling while Factor 2 measures self-efficacy to assess readiness to change and initiate nutrition lifestyle changes. There was high reliability within factors (Factor 1 = 0.946; Factor 2 = 0.927), and the correlation (0.648) between the COP-SE survey and a general self-efficacy survey confirmed that the COP-SE measures domain-specific self-efficacy. This valid and reliable survey can be used by medical schools as a formative or summative assessment of students. self-efficacy in childhood obesity prevention and treatment. Further research should include confirming the factor structure and exploring the significance of response trends seen in this sample. The findings of all three studies can be used by premedical and medical programs to maximize the effectiveness of their preparatory programs to provide students with the necessary skills for prevention and treatment of childhood obesity. With the appropriate preparation, future healthcare providers can build their self-efficacy in disease prevention and treatment, hopefully resulting in improved patient outcomes.
|Advisor:||Goodell, L. Suzanne|
|School:||North Carolina State University|
|School Location:||United States -- North Carolina|
|Source:||DAI-B 75/10(E), Dissertation Abstracts International|
|Subjects:||Nutrition, Health education, Health care management|
|Keywords:||Childhood obesity, Medical education, Nutrition, Premedical education|
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