Patience and persistence pay off for doctors referring children to pediatric obesity clinics, finds U of A research

For families who don’t follow up after an initial referral, one more attempt is often all that’s needed to encourage a visit.

Tarwinder Rai - 01 April 2022

University of Alberta researcher Geoff Ball has found that even if children don’t go to a pediatric obesity clinic after their first referral, patience and persistence on the part of doctors does pay off. Many families who might not follow up on the first referral do end up at one of Alberta’s clinics for obesity management after a second attempt. 

Only about 40 per cent of children referred to obesity-management clinics attend their initial clinic appointment, says Ball. But after analyzing data from 2,745 children in a recent study, Ball found that doctors who remained persistent and re-referred their patients one more time did initiate treatment. In the study, 300 children who had not gone after one referral were referred a second time and ended up attending their appointment. 

“We want physicians who are referring kids to our clinic to know not to give up,” says Ball, a professor and associate chair of research in the Department of Pediatrics, and Alberta Health Services Chair in Obesity Research. “Our data showed that if you refer your pediatric patients, they can still initiate treatment the second time around. So be supportive and don’t give up.”

While he says it’s difficult to know the reasons why some families are not following up on the initial referrals, Ball says for children who are dealing with obesity, getting them the health care they need is crucial. 

“Parents and physicians may think they will grow out of it. But most kids with weights in the obesity category won’t,” says Ball, adding that the psychological, sociological and physiological effects on children dealing with obesity often increase as they age. “A lot of families are referred but never attend, or we see them once and then never again.”

“This health interaction with the clinic can be really beneficial. Many children with high weights have risk factors for chronic illnesses like diabetes and heart disease. If we have services available that are helpful, we want families to utilize them. They’re designed to help kids be as healthy as they can be.”

Ninety-seven per cent of referrals to the pediatric obesity clinic come from family physicians and pediatricians. To identify future opportunities for re-referral, Ball encourages physicians to keep the conversation going with children and their parents on subsequent visits through their interactions. 

“We know obesity has worsened over the last two years with COVID restrictions and limitations placed on our movement,” says Ball. “Clinics like ours across the country are seeing an increase in referrals because of COVID. And now we know, there is value in re-referring if families don’t initiate care the first time around.”

There is also great value in the introduction of virtual medical care, which has made it easier for people to access health care and which puts the resources parents need more quickly into their hands.

“There are a variety of reasons that explain why families do not access health care, but barriers like transportation, parking and time are reduced through virtual care. Families really like the flexibility and availability of virtual services, so having hybrid medical care that combines in-person and virtual health care makes initiating treatment easier than ever,” says Ball. 

Geoff Ball is a member of the Women and Children’s Health Research Institute and the Alberta Diabetes Institute