Endocrine Abstracts

JOINT3395

Introduction: Childhood obesity (CO) is a major public health concern, requiring early and appropriate management. As frontline healthcare providers, family physicians (FPs) play a crucial role in the screening, diagnosis, and treatment of this condition. However, their practices may be influenced by their location and sector of practice, potentially leading to disparities in care quality. This study aims to analyze these differences to identify potential areas for improvement and ensure more standardized and effective management of CO.

Methods: We conducted a cross-sectional descriptive and analytical study using a questionnaire assessing the practices of frontline FPs working in southern Tunisia. Data collection was carried out online or through direct interviews during 2024. Three main areas were evaluated: screening, diagnosis, and treatment of CO. Statistical analysis was performed using SPSS software.

Results: A total of 100 FPs participated, with a mean age of 48±11 years and a female predominance (64%). The majority worked in the public sector (59%) and urban areas (52%). Urban practice was associated with better screening practices (anthropometric assessment performed in 83% of cases, P = 0.017) and more thorough etiological investigations (P = 0.03). Dietary and pharmacological management approaches were similar, except for more personalized dietary counseling in urban settings (P = 0.03). Private-sector practice was significantly associated with better anthropometric and dietary assessment of CO patients (P <0.001 and P = 0.03) and a more individualized management approach (P = 0.04). However, etiological assessment, evaluation of complications, and referral rates to specialist centers were comparable across groups.

Conclusion: Disparities in medical practice quality appear to be widening, particularly in favor of urban areas and the private sector. Our findings highlight more effective CO management in these settings, likely due to better financial resources, easier access to scientific training, greater proximity to specialized centers, and a reduced workload. Strengthening healthcare structures in rural areas and the public sector is essential to ensure equitable CO management.