Nurse-Led Telephone Follow-Up to Improve Parent Promotion of Healthy Behaviors in Young Children With Motivational Interviewing Techniques

Extended brief interventions for weight management and obesity prevention in children: A rapid evidence review

Uptake of child weight management (CWM) support is typically low, and services are not available in all areas. Extended brief interventions (EBIs) have been proposed as an affordable way to provide enhanced support, at a level between one-off brief advice and intensive CWM programs. This rapid systematic review sought to synthesize evidence on the efficacy of EBIs for weight management and obesity prevention in children (2-18 years). Embase and Web of Science were searched from January 2012 to January 2022. Nineteen studies, reporting on 17 separate EBIs, were included. The quality of studies was variable, and the EBIs were heterogeneous. The majority of EBIs (n = 14) were based on motivational interviewing. Five of the included studies reported significant improvements in parent or child determinants of health behavior change. However, robust measures of behavioral determinants were rarely used. No studies reported significant positive effects on child weight. No clear patterns in outcomes were identified. There is currently insufficient evidence for EBIs to be adopted as part of CWM services. To improve the evidence base, EBIs that are currently being implemented by local health services, should be evaluated to establish the most effective content, how it should be delivered, and by whom.

Effect of Nurse-Led Program in Coronary Heart Diseases Patients: A Systematic Review

BACKGROUND: Coronary Heart Diseases (CHD) is one of the leading causes of death worldwide. Proper management for CHD patients is needed to reduce mortality. Nurses have a very important role in making CHD patients can carry out optimal health behaviors. AIM: This review study aims to identify the effect of the nurse-led program on CHD patients. METHODS: This systematic review was based on four electronic databases (Scopus, Science Direct, ProQuest, SAGE Journals) and published between 2011 and 2020. This review used the Joanna Briggs Institute and Prisma guidelines. The study’s eligibility was assessed from the title, abstract, research methodology, and full text. The review results were presented in tabulated data and narrative form. RESULTS: Nine articles showed that the nurse-led program significantly improved health behavior, health-related quality of life, clinical outcome, and illness perception in CHD patients. CONCLUSIONS: It is expected that the improvement of management in CHD patients will improve patients’ quality of life. Hence, it could reduce the number of morbidities and mortality.

Control del sobrepeso y la obesidad en niños y adolescentes por enfermeras: un estudio de métodos mixtos

Resumen Objetivo: analizar el manejo del sobrepeso y la obesidad en niños y adolescentes por las enfermeras de la Estrategia Salud de la Familia (ESF). Método: se trata de un estudio de método mixto paralelo convergente, desarrollado en Centros de Salud (UBS) de un municipio del nordeste de Brasil En la etapa cuantitativa, los datos fueron recolectados a partir de un cuestionario aplicado a 98 enfermeras y evaluados mediante estadística descriptiva. Para la etapa cualitativa, se realizaron entrevistas semiestructuradas con siete enfermeras, interpretadas por análisis temático inductivo. Se combinaron los resultados cuantitativos y cualitativos y se mostraron a través de joint display. Resultados: la mayoría de los enfermeros raramente verificaba el perímetro de cintura (77,6%), la dislipidemia (55,7%), la glucemia (42,3%) y tampoco evaluaba la presión arterial (75,3%). En los resultados cualitativos se identificó que hay enfermeras que no clasificaban el índice de masa corporal según sexo y edad. En cuanto a la solicitación de pruebas, las peticiones se trataban principalmente sobre la rutina asociada a la puericultura. Las orientaciones con respecto a la actividad física y nutrición se efectuaban de forma básica o eran asignadas a otros profesionales, y también no se hizo un seguimiento cuando fueron direccionados a otros servicios o profesionales. Conclusión: existen deficiencias en el conocimiento y la práctica de las enfermeras de atención primaria en el control del sobrepeso y la obesidad en niños y adolescentes. Es imperativo capacitar a los enfermeros para el manejo del sobrepeso y la obesidad en la atención primaria de niños y adolescentes, con miras a la calidad de la atención para la prevención de comorbilidades.

Management of overweight and obesity in children and adolescents by nurses: a mixed-method study

Abstract Objective: to analyze the management of overweight and obesity in children and adolescents by nurses of the Family Health Strategy. Method: this is a study of convergent parallel mixed methods, developed in Health Centers of a municipality in northeastern Brazil. In the quantitative stage, data were collected from a questionnaire applied to 98 nurses and analyzed by descriptive statistics. For the qualitative stage, semi-structured interviews were conducted with seven nurses, interpreted by inductive thematic analysis. The quantitative and qualitative results were integrated and presented by a joint display. Results: most nurses rarely checked waist circumference (77.6%), dyslipidemia (55.7%), blood glucose (42.3%), and neither evaluated blood pressure (75.3%). In the qualitative results, we identified that there are nurses who did not classify body mass index according to sex and age. As for medical tests, the requests were mainly related to the routine of childcare. Guidance on physical activity and diet were given in a basic way or attributed to other professionals, and referrals to other services or professionals were not followed up. Conclusion: it is imperative to train nurses for the management of overweight and obesity in primary care for children and adolescents, with a view to quality of care for the prevention of comorbidities.

Manejo do sobrepeso e obesidade em crianças e adolescentes por enfermeiras: estudo de métodos mistos

Resumo Objetivo: analisar o manejo do sobrepeso e da obesidade de crianças e adolescentes por enfermeiras da Estratégia Saúde da Família. Método: estudo de método misto paralelo convergente, desenvolvido em Unidades Básicas de Saúde, de um município do nordeste brasileiro. Na etapa quantitativa, os dados foram coletados a partir de um questionário aplicado a 98 enfermeiras e analisados por meio de estatística descritiva. Para a etapa qualitativa, foram realizadas entrevistas semiestruturadas com sete enfermeiras, interpretadas pela análise temática indutiva. Os resultados quantitativos e qualitativos foram integrados e apresentados por meio de joint display. Resultados: a maioria dos enfermeiros raramente verificava a circunferência da cintura (77,6%), dislipidemia (55,7%), glicemia (42,3%) e nenhum avaliava a pressão arterial (75,3%). Nos resultados qualitativos, identificamos que há enfermeiros que não classificavam o índice de massa corporal segundo sexo e idade. Quanto aos exames, as solicitações estavam relacionadas principalmente à rotina de puericultura. As orientações sobre atividade física e alimentação foram dadas de forma básica ou atribuídas a outros profissionais, e os encaminhamentos para outros serviços ou profissionais sem seguimento pelos enfermeiros. Conclusão: é imperioso a capacitação dos enfermeiros para o manejo do sobrepeso e obesidade na atenção primária para crianças e adolescentes com vistas a qualidade do atendimento para a prevenção de comorbidades.

Transitioning a home-based, motivational interviewing intervention among families to remote delivery during the COVID-19 pandemic: Key lessons learned

OBJECTIVE

This study examined the experiences, learnings, and strategies of Health Educators (HE) as they transitioned from a home-based model for motivational interviewing (MI) to remote delivery during COVID-19. The overall goal of this paper is to identify key lessons learned to help inform future delivery of remote MI delivery.

METHODS

HE perceptions and experiences regarding the transition from in-person to remote delivery of MI for 21 families were captured through a video recorded discussion. Thematic analysis was used to identify themes and subthemes and key learnings from the transition experience.

RESULTS

Five themes were identified including: 1) Impact of COVID-19 on families; 2) Scheduling, no-shows, and cancellations; 3) Preference of online video versus phone; 4) Building rapport with remote delivery; 5) HE work satisfaction. Based on these results, several key learnings were identified to improve remote MI-counseling, including using online video platforms versus phone calls, providing families the necessary information and technical support to improve acceptability, using specific strategies to enhance rapport and child engagement, and asking probing questions to elicit deeper reflection.

CONCLUSION

Specific considerations regarding rapport building including more frequent check-ins to demonstrate commitment to the family's success, and effective communication strategies including asking more probing questions that elicit complex reflection can support successful transition of MI-counseling from in-person to remote delivery among families with young children.

PRACTICE IMPLICATIONS

Our practice recommendations based on key learnings from MI practitioners during the transition from in-person to remote MI-counseling can support healthcare professionals looking to transition MI-counseling services to remote delivery.

The Influence of Lifestyle Factors on the Burden of Pediatric Migraine

There is a gap in patient education and coaching of lifestyle factors related to pediatric migraine, which nurses are in a unique position to fill in order to provide comprehensive care to these patients. In order to help fill this gap, we conducted a targeted review of studies examining migraine and lifestyle factors in children and adolescents. Studies older than 2010, studies examining adults above the age of 18, studies not available in the English language, and secondary sources were excluded from the review. A final sample of 42 studies was included in this review. Lifestyle factors including stress, sleep, obesity, and diet were identified as playing a significant role in increasing the frequency, severity, and duration of migraine attacks in pediatric patients. Based on these findings, a framework is discussed for practical applications of this knowledge by nursing staff working in primary and specialty care clinics.

Public health nurse referrals for paediatric weight management: A nested mixed-methods study

AIMS AND OBJECTIVES

To (a) characterise and determine proportions of referred and enrolled children and (b) explore public health nurses' (PHNs) experiences, perspectives and recommendations regarding a new nurse-led referral pathway for paediatric weight management.

BACKGROUND

Children with obesity and their families in Canada access specialised services for obesity management through physician referral. Since this requirement can prevent timely access to health services, we established and tested a referral pathway whereby PHNs directly refer children to specialised care for obesity management.

DESIGN

Nested mixed-methods study reported using GRAMMS.

METHOD

Our research study included children (2-17 years of age; body mass index ≥85th percentile) referred by a PHN to the Pediatric Centre for Weight and Health (PCWH; Stollery Children's Hospital, Edmonton, Alberta, Canada) from April 2017-September 2018. We summarised referral and enrolment data using descriptive statistics and conducted one-on-one, semi-structured telephone interviews with PHNs; interviews were audio-recorded, transcribed verbatim, managed using NVivo 12 and analysed by two independent reviewers using content analysis.

RESULTS

Our sample included 79 referred children (4.4 ± 1.8 years old; 3.4 ± 1.3 BMI z-score; 52.7% male), of which 47 (59.5%) enrolled in care. PHNs' (n = 11) experiences, perspectives and recommendations regarding the new referral pathway were grouped into four categories: (a) practicality of the referral pathway (e.g., simple and straightforward), (b) utility of the referral pathway (e.g., economic and timesaving), (c) uptake of the referral pathway (e.g., physician's influence) and (d) recommendations to improve the referral pathway (e.g., having electronic access to the referral form).

CONCLUSIONS

A PHN-specific referral pathway led most children and families to enrol in paediatric weight management and overall was perceived as acceptable and appropriate among PHNs.

RELEVANCE TO CLINICAL PRACTICE

Our results highlight the valuable role that PHNs can play in directly referring children to specialised services for weight management. This pathway has the potential to reduce wait times and enhance treatment enrolment.