Complete this survey to access your toolkit download.

Provider Demographic Information

Where do you work?

Are you a current healthcare provider for children under the age of 18? 
Provider's Education and Area of Specialty
Please select your occupation/specialty. 
What kind of facility do you work in? 
Does your facility utilize an electronic health record? 
Which electronic health record does your facility use? 
How would you rate your overall knowledge about addressing weight and weight management issues with patients? 
Change in Practice Survey (Baseline)

Please answer the following based on your current practice regarding childhood obesity.

Assess BMI and comorbidity risk factors in pediatric patients? 
Follow AAP clinical practice guidelines in obesity management? 
Assess the patient's motivation for weight management and behavior change? 
Discuss weight management, nutrition, and physical activity with families? 
Use motivational interviewing or goal-setting strategies in obesity counseling? 
Refer patients to a dietician or other counselor? 
Connect families with community program for obesity management? 
Use person-first language (e.g., "child with obesity" vs. "obese child") in your communication with families. 
For any questions that you answered "Never" or "Occasionally," what prevents you from performing these practices frequently or always? 
Terms & Conditions