Reduce obesogenic environments for children: the role of nurse practitioners in community-oriented primary care

The purpose of this project is to conduct a critical examination and synthesis of knowledge in the subject area of obesogenic environments contributing to childhood obesity and how nurse practitioner (NP) practice can reduce these factors. The result is a literature review and position paper that concludes with evidence-informed recommendations on the use of the community-oriented primary care practice (COPC) model that are tailored for use by NPs. The critical examination and synthesis of knowledge is designed to address the following clinically significant question: What is the potential for NPs to foster environments that enable a reduction in childhood obesity for Canadian children under the age of 5, using COPC? Approximately 26% of Canadian children ages 2-17 years old are currently overweight or obese and are likely to remain obese as adults. Childhood obesity is a concern for parents, teachers, health care professionals, and public health organizations because of the associated health problems that develop earlier in childhood and will persist into adulthood. In addition, the impact of adult and childhood obesity, and associated chronic diseases, adds a substantial cost to the Canadian health care system. These are incentives to consider the multiple factors contributing to the obesogenic environment and potential areas of intervention. The COPC model is an excellent way to integrate primary care screening and health promotion with population-based health promotion to help reduce obesogenic environments for children. The model can first be applied during the first 5 years of life, as this is a time where primary care providers can take advantage of the periodic health examination to screen for childhood obesity and offer advise to families on diet, exercise, and screen time. The community-based interventions that are part of the COPC model can be aimed at reducing obesogenic environments. Such interventions are within the scope of practice for primary care providers. This paper argues that NPs are well