1
|
Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 199] [Impact Index Per Article: 199.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
|
2
|
Eli K, Neovius C, Nordin K, Brissman M, Ek A. Parents' experiences following conversations about their young child's weight in the primary health care setting: a study within the STOP project. BMC Public Health 2022; 22:1540. [PMID: 35962359 PMCID: PMC9375316 DOI: 10.1186/s12889-022-13803-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In primary healthcare, conversations between clinicians and parents about young children's overweight are key to providing support and initiating weight management. However, given the sensitivity of this topic, these conversations are difficult for both clinicians and parents and are sometimes delayed or avoided. To understand the emotional impact of these conversations, this study aims to shed light on parents' experiences following conversations with primary care nurses about their child's overweight. METHODS Participants were recruited through a childhood obesity randomized controlled trial (RCT) conducted in Sweden. Telephone-based semi-structured interviews were conducted with 17 parents (mean age 40; the majority were women (n = 12/17), had a university degree (n = 14/17) and were born in Sweden (n = 13/16)). Their children were between 3 and 7 years old (mean age 4.8 years) with overweight (n = 7) or obesity (n = 10). The interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS Two main themes were developed. Theme 1, 'Receiving the overweight/obesity diagnosis', explores parents' reactions to the conversation with the primary care nurse. Depending on how the nurse presented the topic, conversations either fostered an alliance between the parent and the nurse, encouraging parents to reflect and develop insights about the child's and the family's needs (subtheme Conversations that empower), or felt limited, uncomfortable, or belittling (subtheme Conversations that provoke resistance). Theme 2, 'Parenting a child with a formal diagnosis of obesity', explores challenges parents faced following the weight conversations, including managing their own feelings and concerns (subtheme Fear of transferring weight anxiety), dealing with others' reactions (subtheme Involve family and manage surroundings) and asking for and receiving support from health care professionals (subtheme Obtain support from health care professionals). CONCLUSIONS While conversations with primary care nurses about children's weight were often emotional, most parents felt these conversations were ultimately helpful, as they encouraged them to enact positive lifestyle changes. Importantly, when nurses initiated conversations in a responsive, non-blaming way, inviting parents to reflect on their situation, parents felt more supported and empowered. These findings convey the importance of providing communication skills training to pediatric healthcare professionals, with particular focus on childhood overweight and obesity. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT03800823 ; 11 Jan 2019.
Collapse
Affiliation(s)
- Karin Eli
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Catharina Neovius
- Regional Unit for the Well-Baby Clinics, Sachsska Children's Hospital, Stockholm, Sweden
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Markus Brissman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska, University Hospital, Stockholm, Sweden
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
3
|
Grey EB, Atkinson L, Chater A, Gahagan A, Tran A, Gillison FB. A systematic review of the evidence on the effect of parental communication about health and health behaviours on children's health and wellbeing. Prev Med 2022; 159:107043. [PMID: 35405179 DOI: 10.1016/j.ypmed.2022.107043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/07/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
Parents report feeling unsure how best to talk with their children about sensitive health topics and may avoid such conversations; yet if children have questions or concerns about their health, talking to a parent could enhance their health and wellbeing. We investigated the effects of parental communications about health and health behaviours on children's health and wellbeing, and explored what strategies can encourage parents to communicate about health. We conducted a systematic review and narrative synthesis of research published between January 2008 and April 2020 from five databases. Of 14,007 articles identified, 16 met inclusion criteria focusing on five topics: diet and weight (n = 5), body image (n = 2), sexual health (n = 7), physical activity (n = 1) and bullying (n = 1). Positive child outcomes were associated with positive general parent-child communication characterised by warmth, openness and allowing children choice. Conversely, hostility, negative and inconsistent messaging were associated with poorer outcomes. Interventions to increase parent-child communication could be classified as providing single directive messages, media campaigns or intensive support. Single messages increased communication frequency; media campaigns and intensive interventions showed mixed outcomes. No differences in outcomes were found according to child's gender or socio-economic status. Generally, parents were less confident in initiating, rather than continuing, conversations and were more likely to initiate conversations when they felt they had good topic knowledge. While the relatively small, diverse sample limits the strength of these findings, this review provides provisional support for approaches to promote positive parent-child communication about health that are associated with better child health and wellbeing.
Collapse
Affiliation(s)
- E B Grey
- Department for Health, University of Bath, Bath BA2 7AY, UK.
| | - L Atkinson
- School of Psychology, Aston University, Birmingham B4 7ET, UK
| | - A Chater
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK
| | - A Gahagan
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, UK
| | - A Tran
- UK Health Security Agency, Department of Health and Social Care, Noble House, 17 Smith Square, London SW1P 3HX, UK
| | - F B Gillison
- Department for Health, University of Bath, Bath BA2 7AY, UK
| |
Collapse
|
4
|
Abstract
While discussing obesity with pediatric patients and their families can be difficult, it is an essential step toward appropriate weight management. There is paucity of data regarding language preferences when discussing obesity in this population. In this pilot qualitative study, we interviewed 8 parents of patients diagnosed with obesity to identify language and communication preferences for discussing their child's weight. Interviews were analyzed for emerging themes. Important trends appeared revealing that parents prefer neutral, medical terms discussed at well-child checks or obesity-specific visits. Providers should frame lifestyle changes as positive for all patients and set achievable goals with the help of visual aids. Our analysis uncovered several important communication strategies that can better equip providers to discuss obesity with their pediatric patients. This research may serve as a foundation for larger studies into the topic.
Collapse
|
5
|
Auckburally S, Davies E, Logue J. The Use of Effective Language and Communication in the Management of Obesity: the Challenge for Healthcare Professionals. Curr Obes Rep 2021; 10:274-281. [PMID: 34003446 PMCID: PMC8408082 DOI: 10.1007/s13679-021-00441-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Initial conversations about weight with patients are important to set the tone for future dialogue and management of obesity. There is often reluctance in raising the topic of overweight or obesity in consultations. We aimed to evaluate literature to discover the perceived barriers to optimal discussion about weight status and preferred weight-based terminology for adults, adolescents and parents of younger children. RECENT FINDINGS Fear of offending patients, insufficient training and lack of knowledge of referral pathways were identified as factors hindering healthcare professionals' ability to discuss weight with patients. Neutral terms, such as 'weight', were preferred by patients, with 'fat' and 'obese' viewed as undesirable and stigmatising words. There is a need for greater support and provision of specific training, including education on communicating weight status, for those involved in the management of obesity. More research is necessary to assess the impact of interventions to improve initial discussions with patients about weight.
Collapse
Affiliation(s)
- Sameera Auckburally
- Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK.
- Department of Paediatrics, Blackpool Victoria Hospital, Whinney Heys Rd, Blackpool, FY3 8NR, UK.
| | - Elena Davies
- Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK
| | - Jennifer Logue
- Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK
| |
Collapse
|
6
|
Evaluation of a Pediatric Obesity Management Toolkit for Health Care Professionals: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147568. [PMID: 34300020 PMCID: PMC8306158 DOI: 10.3390/ijerph18147568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/30/2022]
Abstract
Health care professionals (HCPs) play a critical role in helping to address weight-related issues with pediatric patients, yet often feel ill-equipped to discuss/manage this complex and sensitive health issue. Using the five As ("Ask, Assess, Advise, Agree, and Assist") of Pediatric Obesity Management, we created a series of educational videos and evaluated the content, quality (acceptability, engagement), and impact of these videos on HCPs' self-efficacy, knowledge, and change in practice when addressing weight-related issues with pediatric patients and their families using questionnaires. HCPs (n = 65) participated in a baseline assessment and 4-6 month follow-up (n = 54). Knowledge and self-efficacy increased post-video for the majority of participants. At follow-up, most HCPs reported a change in their practice attributable to viewing the videos, and their self-efficacy ratings improved over time for the majority of questions asked. Most participants rated aspects of each of the videos highly. Preliminary findings suggest that an evidence-based educational toolkit of videos, based on the 5As framework, may lead to changes in self-reported behaviors among HCPs, and sustained improvements in their self-efficacy in addressing weight-related topics with children and their families. (Clinical Trial Number NCT04126291).
Collapse
|
7
|
Davison G, Kelly MA, Conn R, Thompson A, Dornan T. How do children and adolescents experience healthcare professionals? Scoping review and interpretive synthesis. BMJ Open 2021; 11:e054368. [PMID: 34244289 PMCID: PMC8273482 DOI: 10.1136/bmjopen-2021-054368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Explore children's and adolescents' (CADs') lived experiences of healthcare professionals (HCPs). DESIGN Scoping review methodology provided a six-step framework to, first, identify and organise existing evidence. Interpretive phenomenology provided methodological principles for, second, an interpretive synthesis of the life worlds of CADs receiving healthcare, as represented by verbatim accounts of their experiences. DATA SOURCES Five key databases (Ovid Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Web of Science), from inception through to January 2019, reference lists, and opportunistically identified publications. ELIGIBILITY CRITERIA Research articles containing direct first-person quotations by CADs (aged 0-18 years inclusive) describing how they experienced HCPs. DATA EXTRACTION AND SYNTHESIS Tabulation of study characteristics, contextual information, and verbatim extraction of all 'relevant' (as defined above) direct quotations. Analysis of basic scope of the evidence base. The research team worked reflexively and collaboratively to interpret the qualitative data and construct a synthesis of children's experiences. To consolidate and elaborate the interpretation, we held two focus groups with inpatient CADs in a children's hospital. RESULTS 669 quotations from 99 studies described CADs' experiences of HCPs. Favourable experiences were of forming trusting relationships and being involved in healthcare discussions and decisions; less favourable experiences were of not relating to or being unable to trust HCPs and/or being excluded from conversations about them. HCPs fostered trusting relationships by being personable, wise, sincere and relatable. HCPs made CADs feel involved by including them in conversations, explaining medical information, and listening to CADs' wider needs and preferences. CONCLUSION These findings strengthen the case for making CADs partners in healthcare despite their youth. We propose that a criterion for high-quality child-centred healthcare should be that HCPs communicate in ways that engender trust and involvement.
Collapse
Affiliation(s)
- Gail Davison
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- Children's Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Martina Ann Kelly
- Department of Family Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada
| | - Richard Conn
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- General Paediatrics Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Andrew Thompson
- General Paediatrics Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Tim Dornan
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| |
Collapse
|
8
|
Bernard-Genest J, Chu L, Dettmer E, Walsh CM, McPherson AC, Strub J, Steinberg A, Steinegger C, Hamilton JK. Talking About Weight With Families-Helping Health Care Professionals Start the Conversation: A Nonrandomized Controlled Trial. Clin Pediatr (Phila) 2020; 59:910-917. [PMID: 32475155 DOI: 10.1177/0009922820922844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Health care professionals (HCPs) and trainees feel ill-equipped to discuss weight-related issues with children and their families. A whiteboard video for HCPs and trainees outlining strategies to communicate about weight was developed and evaluated. Seventy HCPs, including 15 trainees, participated in the baseline assessment and 39 repeated measures 4 to 6 months later. HCP self-efficacy for initiating conversations with overweight and underweight patients, measured immediately following the video, significantly improved from pre-video values (Z = -5.6, P ≤ .001, and Z= -3.3, P = .001, respectively). Although improvements were not sustained 4 to 6 months later (overweight: P = .143, and underweight: P = .846), no significant decline was observed, suggesting retention of the skill. A majority of HCP respondents would recommend the video to a colleague and feel it will affect their practice. Thus, the present study suggests educational videos may be an effective tool for facilitating healthy weight-related conversations between HCPs and their pediatric patients.
Collapse
Affiliation(s)
- Julie Bernard-Genest
- Centre Hospitalier universitaire de Québec, Université Laval, Québec City, Québec, Canada.,The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lisa Chu
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Amy C McPherson
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Jonah Strub
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Jill K Hamilton
- The Hospital for Sick Children, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
9
|
Klupt KA, Oreskovich SM, Bernard-Genest J, Patel BP, Chu L, Dettmer E, Walsh CM, Strom M, McPherson AC, Strub J, Steinberg A, Steinegger C, Hamilton JK. Careful conversations: an educational video to support parents in communicating about weight with their children. BMC Pediatr 2020; 20:397. [PMID: 32838762 PMCID: PMC7446051 DOI: 10.1186/s12887-020-02284-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Parents may struggle to initiate healthy weight-related conversations with their children. Educational videos may be an effective tool for improving parents' knowledge and self-efficacy on this topic. The aim of this pilot study was to develop an educational video to assist parents in weight-related conversations with their child, and to assess changes in parents' self-efficacy on this topic. METHODS Video development was based on a scoping review and semi-structured interviews with parents. Respondent demographics and user satisfaction were assessed at pre- and post- video, and 4-6 months later. Self-efficacy scores were compared between parent groups based on weight concerns over time. RESULTS Fifty-seven parents participated in the video questionnaires, and 40 repeated measures 4-6 months later. Significant improvements in self-efficacy in "raising the issue of weight" and "answering questions or concerns" were found after watching the video (p ≤ 0.002) compared to baseline, and scores 4-6 months post baseline remained slightly elevated, but non-significant. Parents with concerns about their child being overweight had significantly lower perceived self-efficacy scores compared to parents with no concerns about their child's weight (p = 0.031). The video was found to be positively received and of relevance to parents across a number of different domains. CONCLUSION(S) Preliminary findings suggest an educational video about initiating weight-related conversations may be an effective tool for increasing parents' perceived self-efficacy in the short term. Further work is needed to validate findings in a randomized controlled trial, and with diverse parent populations. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03664492 . Registered 10 September 2018 - Retrospectively registered.
Collapse
Affiliation(s)
- Kody A Klupt
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Stephan M Oreskovich
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Julie Bernard-Genest
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada.,Centre Mère-Enfant Soleil du Centre hospitalier universitaire de Québec, Université Laval, 2705 Boulevard Laurier, Québec City, Québec, G1V4G2, Canada
| | - Barkha P Patel
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Lisa Chu
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Elizabeth Dettmer
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Catharine M Walsh
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Michele Strom
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, East York, Toronto, Ontario, M4G1R8, Canada.,Dalla Lana School of Public Health & Rehabilitation Sciences Institute, University of Toronto, 155 College St, Toronto, Ontario, M5T3M7, Canada
| | - Jonah Strub
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Alissa Steinberg
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Cathleen Steinegger
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada
| | - Jill K Hamilton
- Division of Endocrinology, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada.
| |
Collapse
|
10
|
Ames H, Mosdøl A, Blaasvær N, Nøkleby H, Berg RC, Langøien LJ. Communication of children's weight status: what is effective and what are the children's and parents' experiences and preferences? A mixed methods systematic review. BMC Public Health 2020; 20:574. [PMID: 32345274 PMCID: PMC7189728 DOI: 10.1186/s12889-020-08682-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/08/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Early intervention and conversation about a child's weight may offer an important chance of success in reducing weight and implementing a healthier lifestyle. This review explores the most effective ways to notify parents and children about the child's weight as well as their preferences and experiences around weight notification. METHODS We systematically searched nine databases for relevant primary research. Records were independently screened by two authors. We extracted data into a form designed for this review. Effect data was analysed using narrative synthesis and qualitative data using a best-fit framework synthesis. We assessed our confidence in the evidence using GRADE and GRADE-CERQual. RESULTS Studies of effect found that the format of feedback made little or no difference in parents attending further treatment, recognising their child as overweight or obese, reactions to the way the weight notification is given, motivation for lifestyle change, understanding how to reduce the risk of overweight, or taking any action. However, parents receiving feedback with motivational interviewing have somewhat greater satisfaction with the way the healthcare provider supports them. Qualitative studies found that parents had clear preferences for the format, timing, content and amount of information they wanted to receive in relation to both the weighing process and weight notification. They also had clear preferences for how they wanted health care providers to interact and communicate with them and their children. Both parents and children often felt that they were not receiving enough information and worried about how their results would be kept private. Many parents experienced an emotional response when told about their child's weight ranging from positive, disbelief and negative feelings. Those who reacted with disbelief or negatively were less likely to accept their child's weight status and/or act upon the notification letter. No studies reported results for children who were underweight. CONCLUSIONS Based on these qualitative results people working with weight assessment and notification programs should consider parents' preferences when developing feedback formats, considering the mode of feedback they are going to use and provide parents and children with tailored feedback and personalized follow up once a child is identified as overweight or obese.
Collapse
Affiliation(s)
- H Ames
- The Norwegian Institute of Public Health, Oslo, Norway.
| | - A Mosdøl
- The Norwegian Institute of Public Health, Oslo, Norway
| | - N Blaasvær
- The Norwegian Institute of Public Health, Oslo, Norway
| | - H Nøkleby
- The Norwegian Institute of Public Health, Oslo, Norway
| | - R C Berg
- The Norwegian Institute of Public Health, Oslo, Norway
| | - L J Langøien
- The Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
11
|
Provvidenza CF, Hartman LR, McPherson AC. Fostering positive weight-related conversations between health care professionals, children, and families: Development of a knowledge translation Casebook and evaluation protocol. Child Care Health Dev 2019; 45:138-145. [PMID: 30376689 DOI: 10.1111/cch.12627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health care professionals (HCPs) must communicate with children and families about weight management in a sensitive and nonstigmatizing manner. However, HCPs receive little training in weight-related communication and have requested resources, but these are scarce. This article details the development process of a knowledge translation (KT) Casebook and outlines the proposed protocol for its implementation and evaluation. METHODS Guided by the knowledge-to-action cycle, a KT Casebook aimed at HCPs integrated findings from a comprehensive scoping review with experiential and contextual evidence gathered through stakeholder workshops to provide guidance to HCPs communicating with children and families around weight-related issues. It was structured around five questions: (a) Who should participate in weight-related discussions? (b) When and how should the topic of weight be broached? (c) What terminology should be used? (d) How can HCPs enhance family engagement in weight-related discussions? (e) What specific communication techniques have been recommended? Checklists, evidence summaries, case studies, sentence starters, simulations, and other resources were clustered under each question. A dissemination strategy was developed using KT best practices and a pilot evaluation protocol designed. RESULTS The Casebook was launched in November 2017 and has been presented at pediatric rehabilitation and obesity conferences. A communication strategy targeted multidisciplinary experts and organizations with weight management within their scope of practice. These efforts have resulted in 2,497 downloads across five countries to date. CONCLUSIONS A practical and engaging KT Casebook was created to help foster positive weight-related conversations between HCPs, children, and their families. A pilot implementation study examining the impact of the Casebook on clinical practice will provide critical information for embedding the Casebook in a range of health care settings.
Collapse
Affiliation(s)
- Christine F Provvidenza
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Canada
| | - Laura R Hartman
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| |
Collapse
|
12
|
Walker M, McPherson AC. Weight management services for an underserved population: a rapid review of the literature. Disabil Rehabil 2018; 42:274-282. [DOI: 10.1080/09638288.2018.1497713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Amy C. McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
13
|
Jachyra P, Anagnostou E, Knibbe TJ, Petta C, Cosgrove S, Chen L, Capano L, Moltisanti L, McPherson AC. Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight-Related Topics in Healthcare Consultations. Autism Res 2018; 11:1500-1510. [DOI: 10.1002/aur.2017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/24/2018] [Accepted: 08/08/2018] [Indexed: 01/06/2023]
Affiliation(s)
- Patrick Jachyra
- Bloorview Research Institute; Holland Bloorview Kids Rehabilitation Hospital; Toronto Ontario
- Rehabilitation Sciences Institute; University of Toronto; Toronto Ontario
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics; University of Toronto; Toronto Ontario
| | | | - Catharine Petta
- Holland Bloorview Kids Rehabilitation Hospital; Toronto Ontario
| | - Susan Cosgrove
- Holland Bloorview Kids Rehabilitation Hospital; Toronto Ontario
| | - Lorry Chen
- Holland Bloorview Kids Rehabilitation Hospital; Toronto Ontario
| | - Lucia Capano
- Holland Bloorview Kids Rehabilitation Hospital; Toronto Ontario
| | | | - Amy C. McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital; Dalla Lana School of Public Health, University of Toronto, Rehabilitation Sciences Institute, University of Toronto; Toronto Ontario
| |
Collapse
|
14
|
Jachyra P, Anagnostou E, Knibbe TJ, Petta C, Cosgrove S, Chen L, Capano L, Moltisanti L, McPherson AC. "Girls don't have big tummies": The experiences of weight-related discussions for children with autism spectrum disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1096-1105. [PMID: 30244587 DOI: 10.1177/1362361318793020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Children with autism spectrum disorders appear to be at a higher risk of having obesity than their typically developing peers. Although it has been recommended that healthcare providers speak to children with autism spectrum disorders about the potential health risks of unhealthy weight, no previous research has explored how healthcare providers communicate with them about this topic. The purpose of this study was to explore children's perspectives and experiences of discussing weight-related topics in healthcare consultations. Eight children were interviewed, and an interpretive phenomenological analysis informed the research approach and analysis of the data. Results indicated that weight-related discussions with healthcare providers were often met with trepidation, anxiety, anger, and frustration. Children also expressed that they experienced weight stigma in clinical visits and everyday interactions. Weight stigma was often (unwittingly) projected by healthcare providers during appointments and had debilitating effects on children. Finally, higher weights emerged as a repetitive/restricted interest, and children reported body image challenges regarding their higher weights. Frameworks and tools that are specific to the needs and abilities of children with autism spectrum disorders are needed for healthcare providers to foster positive conversations about weight-related topics in an effort to promote lifelong wellness.
Collapse
Affiliation(s)
- Patrick Jachyra
- 1 Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Canada.,2 Rehabilitation Sciences Institute, University of Toronto, Canada
| | - Evdokia Anagnostou
- 1 Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Canada.,3 Department of Paediatrics, University of Toronto, Canada
| | | | | | - Susan Cosgrove
- 5 Holland Bloorview Kids Rehabilitation Hospital, Canada
| | - Lorry Chen
- 5 Holland Bloorview Kids Rehabilitation Hospital, Canada
| | - Lucia Capano
- 1 Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Canada
| | | | - Amy C McPherson
- 1 Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Canada.,2 Rehabilitation Sciences Institute, University of Toronto, Canada.,6 Dalla Lana School of Public Health, University of Toronto, Canada
| |
Collapse
|