Introduction: The occurrence of childhood obesity has been on the rise since the 1970s; overweight and obesity among children has doubled and even tripled in some age groups, with 6-11 year olds being the most affected. Children living in rural areas of the Southeast are more likely to become overweight and/or obese than those living in other geographical areas of the United States. The lasting effects of childhood obesity contribute to diabetes, cardiovascular disease, and cancer into adulthood. While there are many current studies investigating the actions of pediatricians and family physicians related to childhood obesity, little research has focused solely on the measures implemented by nurse practitioners (NP) in this current epidemic. The purpose of this study is to identify strategies utilized by NPs in the screening and intervention of obesity in children living in rural Southeastern North Carolina.

Methods: A widely accepted method of behavioral analysis, the critical incident technique developed by Flanagan (1954), was used to obtain self reports on the behaviors and activities of NPs related to obesity in children. Health service researchers have used critical incident studies to obtain perspectives of health care providers related to diagnosis and treatment. In this study, a purposive sample of 9 NPs in rural Southeastern North Carolina participated in critical incident interviews focused on screening, defining, and intervention strategies related to childhood obesity. The data obtained through the critical incident interviews were analyzed through the standard procedure developed by Flanagan (1954). A listing of specific activities and behaviors were determined.

Results: Preliminary data analysis indicates that NPs encounter obesity in children on a daily basis. Strategies for intervening with obesity include the use of food and activity diaries, screening for low self esteem and depression, providing education about decreasing TV and video game time, and providing nutrition education on “healthy” eating. Although engaging the parent can prove challenging, a useful approach by NPs includes a focus on “health” as opposed to weight loss. Nurse practitioners emphasized the key role that establishing positive relationships with parents plays in improving weight compliance in children.

Conclusions/Implications: Implications of this study illuminate the increasing need for health care professionals such as NPs to facilitate awareness of childhood obesity and to develop community interventions in this epidemic.