Summaries of Independent Scientist (K) Awards

Barlow, Sarah

Institutions: Saint Louis University, St. Louis, MO, and Baylor College of Medicine, Houston, TX
Grant Title: Improving Obesity Care in Pediatric Offices
Grant Number:  K08 HS13901
Duration: 5 years (2003-2008)
Total Award: $540,000

Project Description: This project has been completed. It had four goals:

1. To describe the current frequency of evaluation of obesity in children 6-17 years of age by pediatricians.
2. To assess experiences and attitudes of pediatricians in diagnosing and discussing this condition, with particular attention to the interpersonal barriers to labeling a child overweight.
3. To assess experiences and attitudes of adolescents, and of parents of elementary school age children in discussing obesity with the pediatrician to learn what approaches are acceptable or alienate or motivate them.
4. To test the effect on pediatricians' self efficacy of an intervention that teaches pediatricians how to address obesity to create an alliance with patients and families and motivate them to make changes.

Career Goals: Dr. Barlow is an Associate Professor of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition at Baylor College of Medicine. She is also the Director for the Obesity Center, Texas Children's Hospital in Houston, TX. Prior to this appointment, she was an Assistant Professor of Pediatrics at the Saint Louis University School of Medicine. She received her MD from the University of Texas, Southwestern Medical Center in Dallas and her MPH in Clinical Effectiveness from Harvard University. She served her Pediatric Residency at Brown University and then went on to a Research Fellow position in the Division of Health Services Research at the Health Institute, New England Medical Center Hospitals in Boston. Later, Dr. Barlow was a Research and Clinical Fellow in the Division of Pediatric Gastroenterology and Nutrition at Tufts. She continues to conduct health services research with a pediatric focus.

Progress to Date: This research found that at an individual patient level, BMI calculation and categorization appeared not to aid recognition in children with established obesity and therefore cannot be expected to result in increased clinical intervention. Further, pediatricians and parents may have non-congruent attitudes and expectations about addressing childhood obesity in the primary care setting.

Highlights and Accomplishments:

• Presented keynote talk for the American Dietetic Association's Course for Certification in Childhood Obesity Treatment.
• Member of a mentoring committee, a project in the department of pediatrics to improve the process for junior faculty members to receive career development guidance.
• Provide medical oversight for pediatric patients enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Trial.

K-Generated Publications:

Cook S, Weitzman M, Auinger P, Barlow SE. Screening and counseling behavior associated with obesity diagnosis in a national survey of ambulatory pediatric visits. Pediatrics 2005. 116:112-16.

Barlow SE, Ohlemeyer CL. Parent reasons for non-return to a pediatric weight management program. Clinical Pediatrics 2006. 45:355-60.

Barlow SE, Bobra SR, Elliott MB, et al. Recognition of childhood overweight during health supervision visits: Does BMI help pediatricians? Obesity 2007. 15(1):225-32.

Barlow SE, Richert M, Baker EA. Putting context in the statistics: Pediatricians' experiences discussing obesity during office visits. Child: Care, Health and Development 2007. 33:416-23.

Barlow SE, Chang JJ. Is parental aggravation associated with childhood overweight? An analysis of the National Survey of Children's Health 2003. Acta Paediatrica 2007. 96:1360-62.

Barlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity; summary report. Pediatrics 2007. 120:S164-92.

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