Parents' perceptions of obesity prevention during infancy: a qualitative study.
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ABSTRACT:
SUBMITTER: Hale I
PROVIDER: S-EPMC6380902 | biostudies-other | 2019 Jan-Mar
REPOSITORIES: biostudies-other
Publications
Parents' perceptions of obesity prevention during infancy: a qualitative study.
Hale Ilona I Amed Shazhan S Keidar Shelly S Purcell Megan M Lee Donna D Farhadi Daniel D
CMAJ open 20190101 1
<h4>Background</h4>Infancy appears to be a critical period for establishing a person's weight set point. It remains unclear which interventions during infancy may be most effective in preventing later obesity and which ones are most acceptable to parents. The aim of this study was to examine the attitudes of parents of children aged 2 years and under toward different obesity prevention messages and their preferences with regard to these messages.<h4>Methods</h4>Using a qualitative research desig ...[more]
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Project description:BACKGROUND:Nurses in child health care (CHC) centers in Sweden play a key role in the early detection and management of childhood overweight/obesity, through meeting families early, regularly and over many years. However, research focusing on CHC nurses' perceptions of their role in childhood overweight/obesity management is scarce. As part of the EU-funded project "Science and Technology in childhood Obesity Policy" (STOP), this study examines CHC nurses' perceptions of speaking to parents about children's overweight/obesity and of their role in referring children to treatment for overweight/obesity. METHODS:All registered CHC nurses in Stockholm County (n?=?442) received an email invitation letter explaining the study. Individual face-to-face visits (n?=?15) in selected centers, and phone calls (n?=?24) to nurses working in these centres were also conducted. In total, 17 CHC nurses (all female, average work experience 6.7?years (SD?±?4.9?years)) from 10 municipalities (including four of the top five municipalities with the highest prevalence of overweight and obesity) in Stockholm County were interviewed. The interviews were conducted by phone, transcribed and analyzed using thematic analysis. RESULTS:Two main themes were developed through the analysis: 1) The relationship between the nurse and the parent and 2) Glitch in the system. Under the first theme, nurses reported that weight-related discussions were facilitated by building and maintaining trust with parents. However, nurses also said they were reluctant to address children's weights if this could compromise parents' trust. Under the second theme, nurses highlighted several organizational barriers to addressing a child's weight with parents, including insufficient cooperation with other healthcare providers and limited time for visits. Nurses also identified lack of sufficient knowledge about what to offer the family and lack of confidence in their communication skills as additional barriers. CONCLUSIONS:We found that pediatric nurses perceive relational and organizational factors as barriers to address childhood obesity with parents. To improve care, it is necessary to provide nurses with continuing education about obesity and communication skills and organizational support to improve communication within the healthcare system. TRIAL REGISTRATION:ClinicalTrials.gov NCT03800823; 11 Jan 2019, prospectively registered.
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Project description:BackgroundPreventing childhood obesity is a public health priority, and primary care is an important setting for early intervention. Authors of a recent national guideline have identified a need for effective primary care interventions for obesity prevention and that parent perspectives on interventions are notably absent from the literature. Our objective was to determine the perspectives of primary care clinicians and parents of children 2-5 years of age on the implementation of an obesity prevention intervention within team-based primary care to inform intervention implementation.MethodsWe conducted focus groups with interprofessional primary care clinicians (n = 40) and interviews with parents (n = 26). Participants were asked about facilitators and barriers to, and recommendations for implementing a prevention program in primary care. Data were recorded and transcribed, and we used directed content analysis to identify major themes.ResultsBarriers existed to addressing obesity-related behaviours in this age group and included a gap in well-child primary care between ages 18 months and 4-5 years, lack of time and sensitivity of the topic. Trust and existing relationships with primary care clinicians were facilitators to program implementation. Offering separate programs for parents and children, and addressing both general parenting topics and obesity-related behaviours were identified as desirable.InterpretationDespite barriers to addressing obesity-related behaviours within well-child primary care, both clinicians and parents expressed interest in interventions in primary care settings. Next steps should include pilot studies to identify feasible strategies for intervention implementation.
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