PRADA - Provider Attitudes on GLP-1 Decision in Adolescents 

This mixed-methods study investigates how healthcare providers make clinical decisions regarding the use of GLP-1 receptor agonists for weight management in adolescents with obesity.  

It explores key influences such as provider comfort, ethical concerns, weight stigma, insurance coverage, and interdisciplinary collaboration to better understand and improve equitable treatment in pediatric obesity care.

In 2023, the American Academy of Pediatrics released the Clinical Practice Guidelines for the Evaluation and Treatment of Children and Adolescents with Obesity, marking a shift toward an ‘early and intensive’ approach. The guidelines included newly approved GLP-1 weight-loss medications for adolescent patients starting at age 12. While met with mixed reviews, including concerns of unintended physical and psychological consequences and risk of exacerbating health inequities due to access barriers, many have expressed that these guidelines provide a plan to approach a population that clinicians have felt challenged to treat.

Nearly two years later, early reports show high utilization of GLP-1 weight loss medications. The Provider Attitudes on GLP-1 Decision in Adolescents (PRADA) Study is interviewing primary care and weight-loss specialized pediatricians from Boston Children’s Hospital, pediatric private practices, and community health centers to better understand the psychosocial, social, structural, and patient factors that impact medical decision making regarding the prescription of weight-loss medications in adolescents, and how this newly approved treatment option shapes weight stigma among clinicians.

The Provider Attitudes on GLP-1 Decision in Adolescents (PRADA) Network is a multidisciplinary collaboration bringing together experts in clinical psychology, medical sociology, adolescent medicine, nutrition, and biostatistics to examine how clinicians make decisions about prescribing GLP-1 weight-loss medications in adolescents. This network is a collaboration between Professors Idia Thurston, Taylor Cruz, and Patrice Williams at Northeastern University; Professor Kendrin Sonneville at the University of Michigan; and Tracy Richmond, an adolescent medicine physician, and Carly Milliren, a biostatistician, at Boston Children’s Hospital. Together, the PRADA network aims to identify the psychosocial, structural, and contextual factors shaping clinicians’ use of GLP-1 medication for adolescents, with two primary aims: (1) conducting in-depth qualitative interviews across diverse clinical settings to understand the drivers of medical decision making, and (2) examining how provider perceptions of weight stigma and health equity influence treatment pathways and access. The team is currently working on both aims.