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Skantze C, Almqvist-Tangen G, Nyholm M, Karlsson S. Parents' Experiences of Communication With School Nurses About Their Child's Weight Development in Sweden. J Sch Nurs 2023:10598405231221050. [PMID: 38130128 DOI: 10.1177/10598405231221050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
This study aimed to describe parents' experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback. The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children.
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Affiliation(s)
- Caroline Skantze
- School of Health and Welfare, Halmstad University, Halmstad, Halland, Sweden
| | - Gerd Almqvist-Tangen
- Department of Paediatrics, University of Gothenburg, Gothenburg, Västra Götaland, Sweden
| | - Maria Nyholm
- School of Health and Welfare, Halmstad University, Halmstad, Halland, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Halland, Sweden
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Jones AR, Mann KD, Cutler LR, Pearce MS, Tovée MJ, Ells LJ, Araujo-Soares V, Arnott B, Harris JM, Adamson AJ. A Randomised Control Trial Investigating the Efficacy of the MapMe Intervention on Parental Ability to Correctly Categorise Overweight in Their Child and the Impact on Child BMI Z-Score Change at 1 Year. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1577. [PMID: 37761538 PMCID: PMC10528244 DOI: 10.3390/children10091577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child's health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4-5- and 10-11-year-old children. Parental categorisation of child weight status was assessed using the question 'How would you describe your child's weight at the moment?' Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change -0.11 (95% CI -0.202 to -0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative.
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Affiliation(s)
- Angela R. Jones
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
- Human Nutrition and Exercise Research Centre, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Kay D. Mann
- Health Capital Division, Queensland Health, 33 Charlotte Street, Brisbane, QLD 4000, Australia;
| | - Laura R. Cutler
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
- Human Nutrition and Exercise Research Centre, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Mark S. Pearce
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
| | - Martin J. Tovée
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Louisa J. Ells
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK;
| | - Vera Araujo-Soares
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, Germany;
| | - Bronia Arnott
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
| | - Julie M. Harris
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9TS, UK;
| | - Ashley J. Adamson
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK (M.S.P.); (B.A.); (A.J.A.)
- Human Nutrition and Exercise Research Centre, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
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Gillison FB, Grey EB, Baber F, Chater A, Atkinson L, Gahagan A. The systematic development of guidance for parents on talking to children of primary school age about weight. BMC Public Health 2023; 23:1704. [PMID: 37667201 PMCID: PMC10476424 DOI: 10.1186/s12889-023-16527-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The prevalence of overweight and obesity in children is increasing, alongside increases in rates of children's anxiety and worry about their weight. In many countries children's weight is measured, and parents are made aware if a child has been classified as having overweight or obesity. However, many parents are concerned that raising their child's awareness of their weight, and talking to children about their weight could harm their wellbeing. The aim of this project was to develop guidance for parents on constructive ways to talk to children of primary school age about weight when they need to. METHODS The project followed a mixed-methods design: Phase 1 involved the collation of evidence including (a) two previously published systematic literature reviews to identify the associations between parent-child weight talk, and broader health discussions, and children's wellbeing, (b) interviews with children, and (c) development and refinement of narrative messaging (previously published). In Phase 2 we developed a conceptual model and mapped primary findings to techniques and content within a draft guidance document for parents on talking to children about weight. Phase 3 involved a modified Delphi process with 29 stakeholders to refine and agree a final version. RESULTS An acceptable draft guidance was agreed following two stages of feedback from Delphi participants. Key areas for debate and adaptation included: encouraging discussion about health and growth with lesser focus on weight; finding ways to reduce stigma and perceptions of blame; emphasising a whole-family approach; inclusive representation of diversity among children and families. CONCLUSIONS Consensus on the content of guidance for parents on talking to children about weight was achieved through a process of evidence review and stakeholder and expert engagement. The next steps are to measure the impact of the resource on improving the experience of parents and children in communicating about weight.
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Affiliation(s)
- Fiona B Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK.
| | - Elisabeth B Grey
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Fran Baber
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Angel 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
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | | | - Alison Gahagan
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, SW1H 0EU, UK
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Baber F, Gillison FB, Grey EB. The acceptability of evidence-informed guidance for parents in talking to their children about weight. BMC Public Health 2023; 23:1357. [PMID: 37452306 PMCID: PMC10349501 DOI: 10.1186/s12889-023-16267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/08/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Many parents express concern about the impact of talking to children about weight on their self-esteem and wellbeing. The aim of this study was to explore the perceived relevance, utility and acceptability of new guidance for parents on talking to children about weight, developed to apply theory, evidence and expert advice into practice. METHODS For this qualitative study, parents and public health practitioners (PHPs) were recruited from ten local authorities in England, through the National Child Measurement Programme between June and September 2021. Participants were sent a copy of the guidance document and took part in an interview approximately one week later. Interviews were transcribed verbatim and explored using thematic analysis. RESULTS 12 parents and 15 PHPs took part, and were similar in their responses reporting the guidance to be acceptable, relevant and helpful. Theme 1 explored how the guidance reduced perceptions of stigma and blame through the perspective and tone that was adopted. Theme 2 explored how the guidance could provide reassurance and increase confidence as a result of case study examples, and specific tips and advice. Theme 3 explored the extent to which participants perceived the advice to be realistic and how it could fit with existing PHP practice. Suggestions for improvement included adapting for relevance for lower income families and providing separate advice for parents of older and younger children. CONCLUSIONS The guidance was perceived as relevant and needed; it showed potential to reduce parents' negative affect and concerns, and improve confidence around talking to children about weight.
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Affiliation(s)
- Fran Baber
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Fiona B Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Elisabeth B Grey
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Whitfield H, Hargreaves D, Nicholls D, Watt HC, Creese H. Risk factors of persistent adolescent thinness: findings from the UK Millennium Cohort Study. BMC Public Health 2023; 23:938. [PMID: 37226159 DOI: 10.1186/s12889-023-15850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 05/09/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Thinness during adolescence can increase the risk of adverse health outcomes across the life-course and impede development. There is limited research examining the prevalence and determinants of persistent adolescent thinness in the United Kingdom (UK). We used longitudinal cohort data to investigate determinants of persistent adolescent thinness. METHODS We analyzed data from 7,740 participants in the UK Millennium Cohort Study at ages 9 months, 7, 11, 14 and 17 years. Persistent thinness was defined as thinness at ages 11, 14 and 17; thinness was defined as an age- and sex-adjusted Body Mass Index (BMI) of less than 18.5 kg/m2. In total, 4,036 participants, classified either as persistently thin or at a persistent healthy weight, were included in the analyses. Logistic regression analyses were conducted to examine associations between 16 risk factors and persistent adolescent thinness by sex. RESULTS The prevalence of persistent thinness among adolescents was 3.1% (n = 231). Among males (n = 115), persistent adolescent thinness was significantly associated with non-white ethnicity, low parental BMI, low birthweight, low breastfeeding duration, unintended pregnancy, and low maternal education. Among females (n = 116), persistent adolescent thinness was significantly associated with non-white ethnicity, low birthweight, low self-esteem, and low physical activity. However, after adjusting for all risk factors, only low maternal BMI (OR: 3.44; 95% CI:1.13, 10.5), low paternal BMI (OR: 22.2; 95% CI: 2.35, 209.6), unintended pregnancy (OR: 2.49; 95% CI: 1.11, 5.57) and low self-esteem (OR: 6.57; 95% CI: 1.46,29.7) remained significantly associated with persistent adolescent thinness among males. After adjustment for all risk factors, not reaching the recommended physical activity levels (OR: 4.22; 95% CI: 1.82, 9.75) remained significantly associated with persistent adolescent thinness among females. No appreciable associations were found between persistent adolescent thinness and sex, premature birth, smoking during pregnancy, income, maternal postnatal depression, mother-infant attachment or socio-emotional difficulties (p > 0.05). CONCLUSION Persistent adolescent thinness is not rare and appears to be associated with both physical and mental health factors, with some sex specific differences. Healthy weight initiatives should consider the full weight spectrum. Further research is required to understand thinness at a population level, including among those whose BMI changes during child and adolescent development.
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Affiliation(s)
- H Whitfield
- School of Public Health, Imperial College London, London, UK.
| | - D Hargreaves
- School of Public Health, Imperial College London, London, UK
| | - D Nicholls
- Department of Brain Sciences, Imperial College London, London, UK
| | - H C Watt
- School of Public Health, Imperial College London, London, UK
| | - H Creese
- School of Public Health, Imperial College London, London, UK
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Koivumäki T, Jallinoja P. The good, the bad, and the blameless in parenting: a thematic analysis of discussions of childhood obesity on an internet forum. BMC Public Health 2023; 23:452. [PMID: 36890492 PMCID: PMC9993749 DOI: 10.1186/s12889-023-15314-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/23/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Childhood obesity is affecting an increasing percentage of families globally. For families, obesity is often a tense issue, not least because of the negative stigma and cultural perceptions associated with it. Discussions around childhood obesity do not take place only at home or in healthcare, but increasingly on social media, such as Internet discussion forums. Our aim was to analyse how childhood obesity is discussed on a Finnish online discussion forum by parents of children with obesity and other commenters. METHOD We gathered and analysed 16 discussion threads on childhood obesity taken from a Finnish Internet discussion forum, vauva.fi, between 2015 and 2021 (a total of 331 posts). For the analysis, we chose threads where the parents of a child with obesity took part. The parents' and other commenters' discussions were analysed and interpreted with inductive thematic analysis. RESULTS In the online discussions, childhood obesity was discussed mostly in the context of parenting, parental responsibility and lifestyle choices within the family. We identified three themes that were used to define parenting. In the theme of proving good parenting, parents and commenters listed healthy elements in their family's lifestyle to show their responsibility and parenting skills. In the theme of blaming bad parents, other commenters pointed out mistakes in the parents' behaviour or offered them advice. Moreover, many acknowledged that some factors causing childhood obesity were outside the parents' influence, forming the theme of lifting the blame from parents. In addition, many parents brought up that they were genuinely ignorant of the reasons for their child's overweight. CONCLUSIONS These results are in line with previous studies suggesting that in Western cultures obesity - including childhood obesity - is typically seen as the individual's fault and is associated with negative stigma. Consequently, counselling parents in healthcare should be expanded from supporting a healthy lifestyle to strengthening parents' identity as being good enough parents who are already making many health enhancing efforts. Situating the family in a wider context of the obesogenic environment could ease the parents' feelings that they have failed at parenting.
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Hawking MKD, Dezateux C, Swinglehurst D. Weighing up the future: a meta-ethnography of household perceptions of the National Child Measurement Programme in England. CRITICAL PUBLIC HEALTH 2023. [DOI: 10.1080/09581596.2023.2169599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
| | - Carol Dezateux
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Deborah Swinglehurst
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Koivumäki T, Kääriäinen M, Tuomikoski AM, Kaunonen M. Parent and carer experiences of health care professionals' communication about childhood obesity: a qualitative systematic review protocol. JBI Evid Synth 2023; 21:401-406. [PMID: 36059227 PMCID: PMC9901846 DOI: 10.11124/jbies-22-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the systematic review is to identify, critically appraise, and synthesize the best available qualitative evidence on parent and carer experiences of health care professionals' communication about childhood obesity. INTRODUCTION Parents and carers play a key role in a child's environment and healthy development, which is why they can find it confronting to discuss their child's weight. This review will provide an insight into the experiences of parents and carers with health care professionals' communication about their child's overweight or obesity. INCLUSION CRITERIA This qualitative review will consider participants who are parents and carers with a child with overweight or obesity (birth to 12 years). The phenomenon of interest is parents' and carers' lived experiences of childhood obesity communication from a health care professional, and the context is health care settings. Communication includes verbal or written communication about a child's obesity from health care professionals received by a parent or carer. METHODS The proposed review will systematically search the following databases: MEDLINE (EBSCO), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, LILACS, and the Finnish health sciences database MEDIC. ProQuest Dissertations and Theses (ProQuest) will be searched for unpublished articles. A manual search will supplement the database searches. The quality of included studies will be assessed independently by 2 reviewers, and the qualitative data will be extracted from papers by 2 independent reviewers using the standardized JBI data extraction tool. The recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis meta-aggregation will be used. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42022297709.
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Affiliation(s)
- Terhi Koivumäki
- Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Maria Kääriäinen
- Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland.,Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Oulu University Hospital, Finland
| | - Anna-Maria Tuomikoski
- Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland.,Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Oulu University Hospital, Finland
| | - Marja Kaunonen
- Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Oulu University Hospital, Finland.,General Administration, Pirkanmaa Hospital District, Tampere, Finland
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McSweeney L, Arnott B, Jones A, Cain G, Jenkins J, Andras A, Adamson A. Challenges and opportunities of remote public involvement and community engagement during a pandemic: refining the MapMe childhood healthy weight intervention. Perspect Public Health 2022; 142:224-230. [PMID: 35766321 PMCID: PMC9284084 DOI: 10.1177/17579139221110015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Including parents and other stakeholders in the development of interventions to address the sensitive public health issues such as childhood obesity, through public involvement is critical. However, the Covid-19 pandemic has created a challenge for public involvement and engagement activities (PICE). The aim of this paper is to describe the process and challenges of setting up, maintaining, evaluating, and recording impact of three public and stakeholder groups via remote methods in the context of the MapMe2 study during the Covid-19 pandemic. Parental reaction to result letters received as part of the National Child Measurement Programme (NCMP) informing parents of their child's overweight status is often one of hostility or disbelief. As a result, parents often do not act on these letters to address child overweight. The MapMe2 study is working in collaboration with the NCMP and local authorities, building on previous work (MapMe) and aims to support parents of primary school-aged children to recognise and maintain a healthy weight in their child. The existing MapMe Intervention includes an enhanced NCMP child weight result letter, supplemented with Body Image Scales (BIS), and an intervention website with material to support healthy eating, physical activity, and signposting supporting information. The intervention was to be refined and the evaluation informed with PICE input. METHODS Covid-19 restrictions meant that planned face-to-face PICE methods had to be altered with all recruitment, all correspondence, and activities taking place remotely. A Parent Involvement Panel (PIP), a child panel, and an expert panel were established. Several adaptations were made to accommodate a new way of involving the public in research. RESULTS/CONCLUSIONS Working remotely created many challenges and was a learning experience for all involved. However, an active group was successfully established. Using continuous assessment and evaluation methods, we were able to demonstrate successful involvement and engagement in the refinement of the MapMe2 study. Through the sharing of PICE methods practice, this paper adds to the literature, the value of partnership working.
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Affiliation(s)
- L McSweeney
- Population Health Sciences Institute, Newcastle University, Framlington Place, Newcastle upon Tyne, UK
| | - B Arnott
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - A Jones
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - G Cain
- Public and Involvement Group Parent Representative
| | - J Jenkins
- Public and Involvement Group Parent Representative
| | - A Andras
- Public and Involvement Group Parent Representative
| | - A Adamson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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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.
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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
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Exploration of Barriers and Facilitators to Implementing Best Practice in Exercise Medicine in Primary Pediatric Care-Pediatrician Perspectives. Pediatr Exerc Sci 2021; 33:162-169. [PMID: 34167088 DOI: 10.1123/pes.2020-0214] [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: 09/30/2020] [Revised: 02/25/2021] [Accepted: 03/14/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Despite the known health benefits of physical activity (PA), few primary care pediatricians discuss, evaluate, or prescribe PA for children. The goal of this study was to examine pediatricians' thoughts and practices related to child PA and the perceived facilitators and barriers to implementing PA evaluation and prescription in pediatric primary care clinics. METHODS The Consolidated Framework for Implementation Research was used to explore implementation barriers and facilitators. A mixed-method design combined questionnaires and focus groups with 27 pediatricians. RESULTS Despite the pediatricians' beliefs that PA is important for patients, there was wide practice variability in their approaches to discussing PA. Several perceived barriers to implementing PA evaluation and prescription were identified, including lack of knowledge and training, managing time for PA with multiple demands, the need for a team approach and simple PA tools and resources, support for patient tailoring of PA messaging, and a need for PA best practice champions. CONCLUSION The identified barriers to implementing evidence in PA suggest several directions for improvement, including a care-team approach; quick, inexpensive, and simple PA tools; community PA partnerships; PA training in medical education; evidence-based strategies; and PA directories for families. These efforts could facilitate the implementation of PA best practices in pediatrics.
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Firman N, Boomla K, Hudda MT, Robson J, Whincup P, Dezateux C. Is child weight status correctly reported to parents? Cross-sectional analysis of National Child Measurement Programme data using ethnic-specific BMI adjustments. J Public Health (Oxf) 2021; 42:e541-e550. [PMID: 31950165 PMCID: PMC7685848 DOI: 10.1093/pubmed/fdz188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 11/14/2022] Open
Abstract
Background BMI underestimates and overestimates body fat in children from South Asian and Black ethnic groups, respectively. Methods We used cross-sectional NCMP data (2015–17) for 38 270 children in three inner-London local authorities: City & Hackney, Newham and Tower Hamlets (41% South Asian, 18.8% Black): 20 439 4–5 year-olds (48.9% girls) and 17 831 10–11 year-olds (49.1% girls). We estimated the proportion of parents who would have received different information about their child’s weight status, and the area-level prevalence of obesity—defined as ≥98th centile—had ethnic-specific BMI adjustments been employed in the English National Child Measurement Programme (NCMP). Results Had ethnic-specific adjustment been employed, 19.7% (3112/15 830) of parents of children from South Asian backgrounds would have been informed that their child was in a heavier weight category, and 19.1% (1381/7217) of parents of children from Black backgrounds would have been informed that their child was in a lighter weight category. Ethnic-specific adjustment increased obesity prevalence from 7.9% (95% CI: 7.6, 8.3) to 9.1% (8.7, 9.5) amongst 4–5 year-olds and from 17.5% (16.9, 18.1) to 18.8% (18.2, 19.4) amongst 10–11 year-olds. Conclusions Ethnic-specific adjustment in the NCMP would ensure equitable categorization of weight status, provide correct information to parents and support local service provision for families.
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Affiliation(s)
- Nicola Firman
- Centre for Primary Care & Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Kambiz Boomla
- Centre for Primary Care & Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Mohammed T Hudda
- Population Health Research Institute, St George's, University of London, London SW17 0RE, UK
| | - John Robson
- Centre for Primary Care & Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Peter Whincup
- Population Health Research Institute, St George's, University of London, London SW17 0RE, UK
| | - Carol Dezateux
- Centre for Primary Care & Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
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Humphrey G, Dobson R, Parag V, Hiemstra M, Howie S, Marsh S, Morton S, Mordaunt D, Wadham A, Bullen C. See How They Grow: Testing the feasibility of a mobile app to support parents' understanding of child growth charts. PLoS One 2021; 16:e0246045. [PMID: 33606687 PMCID: PMC7894826 DOI: 10.1371/journal.pone.0246045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/11/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mobile devices provide new opportunities for the prevention of overweight and obesity in children. We aimed to co-create and test an app that offered comprehensible feedback to parents on their child's growth and delivered a suite of age-specific information about nutrition and activity. METHODS A two-phased approach was used to co-create the digital growth tool-See How They Grow-and test its feasibility. Phase one used focus groups (parents and professionals such as paediatricians and midwives) and a national on-line survey to gather requirements and build the app. Phase two involved testing the app over 12-weeks, with parents or carers of children aged ≤ 2-years. All research activities were undertaken exclusively through the app, and participants were recruited using social media and hard copy materials given to patents at a child health visit. FINDINGS Four focus groups and 101 responses to the national survey informed the features and functions to include in the final app. Two hundred and twenty-five participants downloaded the app, resulting in 208 eligible participants. Non-Māori/Non-Pacific (78%) and Māori (14%) had the highest downloads. Fifty-four per cent of participants were parents of children under 6-months. These participants were more likely to regularly use the app than those with children older than 6-months (64% vs 36%, P = 0.011). Over half of the participants entered three measures (n = 101, 48%). Of those that completed the follow-up survey (n = 101, 48%), 72 reported that the app helped them better understand how to interpret growth charts. CONCLUSION The app was acceptable and with minor modifications, has the potential to be an effective tool to support parents understanding of growth trajectories for their children. A larger trial is needed to evaluate if the app can have a measurable impact on increasing knowledge and behaviour, and therefore on preventing childhood overweight and obesity.
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Affiliation(s)
- Gayl Humphrey
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Rosie Dobson
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Varsha Parag
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | | | - Stephen Howie
- Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Samantha Marsh
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Susan Morton
- Growing Up in New Zealand, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Dylan Mordaunt
- University of Adelaide, South Australia, Australia
- Flinders University, South Australia, Australia
| | - Angela Wadham
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
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Castor C, Derwig M, Borg SJ, Ollhage ME, Tiberg I. A challenging balancing act to engage children and their families in a healthy lifestyle - Nurses' experiences of child-centred health dialogue in child health services in Sweden. J Clin Nurs 2021; 30:819-829. [PMID: 33377556 DOI: 10.1111/jocn.15622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/26/2020] [Accepted: 12/10/2020] [Indexed: 01/03/2023]
Abstract
AIMS AND OBJECTIVES To describe nurses' experiences of a child-centred family guided intervention of obesity tested within the child health services targeting children identified with overweight and their caregivers. BACKGROUND Interventions aiming to support families towards a healthier lifestyle can lead to decreased risk of overweight evolving into obesity in a child. At the same time, nurses have found dialogues on weight challenging and may therefore avoid them. DESIGN Qualitative descriptive inductive design following content analysis applying to the COREQ guidelines. METHODS Content analysis was used to analyse 13 individual semi-structured interviews with nurses in the child health service in Sweden after completed training in CCHD, including how to facilitate the dialogue with the use of illustrations. RESULTS The theme Health dialogue about weight is a challenging balancing act facilitated by a supportive intervention emerged through eight subcategories in three main categories. Nurses experienced that CCHD with children identified with overweight and their caregivers provoked an emotional response both for themselves and for the caregivers of the child. The training in child-centred health dialogues promoted the nurses' work with structure and professionalism, as the nurses carefully took tentative steps to engage the family for a healthy lifestyle. CONCLUSIONS Emotional and practical challenges in performing CCHD still remained among nurses after customised training, which might comprise the child's rights to be involved in his or her own care when the child was identified as overweight. However, training for nurses, including lectures and tutorials, was found to increase the quality and professionalism of performing CCHD by providing structure, tools and tutorial support. RELEVANCE TO CLINICAL PRACTICE Customised training and illustrations can support nurses when performing a structured intervention such as child-centred health dialogues.
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Affiliation(s)
- Charlotte Castor
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Mariette Derwig
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | | | - Iren Tiberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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15
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Delivery of the National Child Measurement Programme in England. Public Health Nutr 2020; 24:1177-1184. [PMID: 33292917 DOI: 10.1017/s1368980020004991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The National Child Measurement Programme (NCMP) is a mandatory initiative delivered in England to children in Reception and Year 6. To date, no research has explored the methods used to deliver the NCMP by Local Government Authorities (LGA) across England. DESIGN An online survey was administered between February 2018 and May 2018 to explore the delivery of the NCMP across the 152 LGA in England and disseminated using non-probability convenience sampling. SETTING LGA received an anonymous link to the survey. PARTICIPANTS A total of 92 LGA participated in the survey. RESULTS Most LGA who responded provide result feedback (86 %), a proactive follow-up (71 %) and referrals to services (80 %). Additionally, 65 % of the authorities tailor Public Health England specimen result letters to suit their needs, and 84 % provide attachments alongside. Out of 71 % of LGA who provide proactive follow-up, 19 (29 %) provide the proactive follow-up only to upper weight categories and only 4 (6 %) include Healthy Weight category with other categories in proactive follow-up. Regarding the service availability for children, out of 80 % of LGA who indicated that services are available, 32 (43 %) targeted solely upper weight categories, while the other 42 (57 %) offered services across all weight categories. Finally, most LGA (88 %) commission providers to manage various parts of the NCMP. CONCLUSIONS The results show that LGA in England localise the NCMP. Further guidance regarding standards of best practice would help LGA to find the most suitable localisation out of various options that exist across other LGA.
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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.
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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
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Noonan-Gunning S. Social Implications of Weight Bias Internalisation: Parents' Ultimate Responsibility as Consent, Social Division and Resistance. Front Psychol 2019; 10:2321. [PMID: 31824361 PMCID: PMC6881380 DOI: 10.3389/fpsyg.2019.02321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 09/27/2019] [Indexed: 11/24/2022] Open
Abstract
Responsibility is a moral quality of caring that is central to child health policies. In contemporary United Kingdom these policies are based on behavioural psychology and underpinned by individualism, an ideology central to neoliberal governance. Amid the complexities of “obesity” and inequalities, there is a multi-layered stigmatisation of parents as moral associates. Few studies consider the lived realities of food policy processes from the standpoint of class. This critical qualitative research draws on theorists who explain processes of power and class: Foucault, Gramsci, Bourdieu, and Marx. Its objectives are: (a) to understand the lived experience of parents as they interact with food policy; (b) to explore how parents resist stigmatisation; and (c) to reflect on implications for policy and practice.
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18
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Firman N, Dezateux C. Does parental concern about their child's future risk of overweight vary by their ethnic background? Cross-sectional analysis of a national cohort study. BMJ Open 2019; 9:e027226. [PMID: 31471432 PMCID: PMC6720322 DOI: 10.1136/bmjopen-2018-027226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Children from South Asian ethnic backgrounds are at increased risk of obesity and its associated future health risks; however, evidence is lacking as to whether parental concern about their child's future overweight risk varies by ethnic background. We hypothesised that parents of 5-year-old children from South Asian backgrounds would be more likely to express such concerns. DESIGN Cross-sectional. SETTING UK. PARTICIPANTS 15 039 singleton 5-year-old Millennium Cohort Study participants (48.9% girls; 86.7% White). PRIMARY OUTCOME MEASURE Parent-reported concern (some/none) about future overweight risk. METHODS We estimated the adjusted ORs (aORs) of some parental concern (ranging from a little to very concerned) by child's ethnic background (reference group: White), adjusted for parent and child weight status, and child sex. RESULTS Parents of girls from Pakistani (aOR 0.4; 95% CI 0.2 to 0.5), Bangladeshi (0.3; 0.2 to 0.5), Black African (0.5; 0.3 to 0.7) and Mixed (0.7; 0.5 to 0.99) ethnic backgrounds and of boys from Pakistani ethnic backgrounds (0.6; 0.4 to 0.9) were less likely to report concern about their child's future overweight risk than parents of White girls and boys, respectively. Overweight (2.5; 2.2 to 2.8) and obesity (6.7; 5.7 to 7.9) in children, and overweight (1.4; 1.2 to 1.5) and obesity (1.9; 1.7 to 2.2) in parents, were associated with increased likelihood of concern. CONCLUSIONS Parents of children from South Asian ethnic backgrounds express less concern about their child's future overweight risk. Qualitative studies are needed to understand the concerns of parents from different ethnic backgrounds to inform weight-management interventions in ethnically diverse populations.
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Affiliation(s)
- Nicola Firman
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Carol Dezateux
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Dam R, Robinson HA, Vince-Cain S, Heaton G, Greenstein A, Sperrin M, Hassan L. Engaging parents using web-based feedback on child growth to reduce childhood obesity: a mixed methods study. BMC Public Health 2019; 19:300. [PMID: 30866878 PMCID: PMC6415344 DOI: 10.1186/s12889-019-6618-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 03/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To measure trends in child growth and combat rising levels of obesity, Manchester University NHS Foundation Trust and the University of Manchester have developed Children's Health and Monitoring Programme (CHAMP). CHAMP collects an annual measurement for primary school children (aged 4 to 11) in Manchester, England, and offers feedback of Body Mass Index (BMI) results to parents via a secure website. No similar digital tool exists that both provides high resolution data on the trajectory of child growth and acts as a feedback and monitoring system. This study investigates how effectively this intervention engaged with parents and supported the reduction of childhood obesity. METHODS Anonymised CHAMP registration and BMI data (UK1990) were collected between September 2013 and March 2017 from a total of 63,337 children. BMI change over time was compared in matched cohorts of 24,551 children, whose parents had and had not registered with the CHAMP website. Qualitative focus groups and interviews were used to explore perspectives among 29 key informants (parents, school and healthcare professionals) from six schools in Manchester. RESULTS Overweight children whose parents had not registered with the CHAMP website gained a median of 0.14 BMI centile between measurements, whilst children of CHAMP-registered parents reduced their BMI by a median of 0.4 centile per year (P = 0.02). Normal weight children of registered parents decreased their BMI by 0.3 centile each year, whilst those not registered increased their BMI by 0.8 centile per year (P = 0.001). There was no significant association between registration and BMI centile change in children already classified as obese (P = 0.34). A qualitative, thematic analysis revealed that the annual measurement programme was widely supported by parents and staff. A range of psychological and behavioural impacts on families were reported as a result of the monitoring and feedback processes, in some cases prompting reflection and monitoring of health and lifestyle choices. CONCLUSION These early findings indicate that CHAMP, as both a monitoring system and a digital intervention, could encourage positive lifestyle change and support healthier child growth trajectories.
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Affiliation(s)
- Rinita Dam
- Radcliffe Department of Medicine, Medical Sciences Division, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU UK
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Heather Anne Robinson
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Gill Heaton
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Adam Greenstein
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Matthew Sperrin
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Lamiece Hassan
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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20
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Kovacs BE, Gillison FB, Barnett JC. Is children's weight a public health or a private family issue? A qualitative analysis of online discussion about National Child Measurement Programme feedback in England. BMC Public Health 2018; 18:1295. [PMID: 30477468 PMCID: PMC6257949 DOI: 10.1186/s12889-018-6214-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023] Open
Abstract
Background The National Child Measurement Programme (NCMP) is a child weight monitoring system in England, taking place in the first and final years of primary school. Many local authorities consider it important to inform parents if their child is overweight, and do so by letter alongside the offer of support and advice. Such letters have been met with mixed reactions from parents, but research seeking to better understand parents’ responses is often limited by reliance on survey data and low participation rates. This study aimed to collect a broad variety of perspectives on the programme by analyzing views expressed in parent-to-parent discussions posted online. Methods UK-based online parenting fora were used to identify discussion threads based around the NCMP between 2010 and 2017. Thirty-one discussion threads from two parent fora were identified. Thematic analysis was used to identify themes in these data. Results The primary themes identified related to (1) the legitimacy of feedback and judgement from health professionals, (2) the relative importance of collecting population level data above individual preferences, and (3) risks versus benefits of having conversations with children about weight. Most threads adopted an ‘argument, counter-argument’ format, providing two sides to each issue raised. Information and opinions consistent with public health messages were frequently provided, such as how data are used, that feedback is intended to be helpful, and the importance of collecting national data. There was little evidence of individual parents shifting their views in response to others’ arguments. Conclusions This study provides novel insight into peer-to-peer debates about the NCMP, including the arguments parents find convincing and acceptable for and against a national programme to weigh children and provide feedback to parents about their weight. Online fora were used as an opportunity to express criticism or distress, but also to seek advice from peers regarding concerns about whether or not to opt-out. Thus, both general issues related to the legitimacy of population screening and outcomes for individual children were of concern to parents.
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Affiliation(s)
- B E Kovacs
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - F B Gillison
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - J C Barnett
- Department of Psychology, University of Bath, Bath, UK
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Bray I, Slater A, Lewis-Smith H, Bird E, Sabey A. Promoting positive body image and tackling overweight/obesity in children and adolescents: A combined health psychology and public health approach. Prev Med 2018; 116:219-221. [PMID: 30144484 DOI: 10.1016/j.ypmed.2018.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/31/2018] [Accepted: 08/21/2018] [Indexed: 12/11/2022]
Abstract
This article draws attention to the dual global problems of disordered eating and overweight/obesity among children and adolescents. It is well recognised that the main risk factor for disordered eating is body dissatisfaction, yet public health messages to tackle overweight/obesity are likely to increase body dissatisfaction. This tension between key public health messages and a health psychology approach is examined, with the goal of seeking a common way forward. We focus on the UK as a case study, where there is currently no statutory education in schools on body image. Since more prescriptive guidance on the curriculum covering personal/social/health issues is soon to be introduced, it is timely to consider the content, and in particular its impact on body image as well as overweight/obesity. Having reviewed current interventions and policy, we argue for a more holistic approach to the obesity problem, using a whole school approach to create a body confident culture.
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Affiliation(s)
- Isabelle Bray
- Centre for Public Health and Wellbeing, University of the West of England, UK.
| | - Amy Slater
- Centre for Appearance Research, University of the West of England, UK
| | | | - Emma Bird
- Centre for Public Health and Wellbeing, University of the West of England, UK
| | - Abigail Sabey
- Centre for Public Health and Wellbeing, University of the West of England, UK
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22
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Davidson K, Vidgen H, Denney-Wilson E, Daniels L. How is children's weight status assessed for early identification of overweight and obesity? - Narrative review of programs for weight status assessment. J Child Health Care 2018; 22:486-500. [PMID: 29439599 DOI: 10.1177/1367493518759238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Assessment of a child's weight status is the first step in the management of childhood overweight and obesity. We reviewed routine assessment programs to inform early and routine identification of childhood overweight and obesity to address this global health issue. Twelve electronic databases were searched (Scopus, Web of Science, Wiley, ScienceDirect, PsycINFO, PsycARTICLES, PsycEXTRA, CINAHL, Primary Search, MEDLINE, ERIC, Academic Search Elite) for universal programs for weight status assessment of children aged 4-12 in Organization for Economic Co-operation and Development - countries, which included more than one assessment and parents receiving feedback. Of 1638 papers found via database searches, and 18 additional records identified through other sources, 26 were included. Reference to five countries' programs for weight status assessment was found in the results: Australia, Sweden, the Netherlands, the United Kingdom and the United States. All of these programs were implemented in a school setting. Lack of services, stakeholder collaboration, parental awareness and engagement and government funding need to be improved for this health check to be undertaken as a part of an ongoing program. This review is about the implementation of similar programs. Early identification of risk for overweight and obesity allows families that require help to connect with available health services.
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Affiliation(s)
- Kamila Davidson
- 1 School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Helen Vidgen
- 1 School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Lynne Daniels
- 1 School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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23
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Villarosa AR, George D, Ramjan LM, Srinivas R, George A. The role of dental practitioners in addressing overweight and obesity among children: A scoping review of current interventions and strategies. Obes Res Clin Pract 2018; 12:405-415. [PMID: 30082247 DOI: 10.1016/j.orcp.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/22/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION With the growing prevalence of childhood obesity worldwide, there is a need for interventions to identify and address overweight and obesity in childhood. Although guidelines recommend general practitioners routinely screen for overweight and obesity among children, research suggests this is often not done. To address this, dental practitioners may be able to play a role in identifying and addressing overweight and obesity among children. METHODS This review aimed to explore the evidence and efficacy of existing obesity and overweight interventions targeting children in the dental setting. A systematic search of nine electronic databases was conducted to identify relevant published and grey literature. This was expanded to also include strategies for promoting oral health in the dental setting. RESULTS A total of 11 records were included in this review, which focussed on the current role and effectiveness of dental practitioners in addressing obesity among children, and the available strategies and resources. Although there was a paucity of research on the training of dental practitioners in this area and their efficacy in identifying and addressing obesity among children, evidence suggests that parents found it acceptable for dental practitioners to promote healthy practices to children who experience overweight or obesity. This review also identified screening tools and strategies for identifying and addressing overweight and obesity among children in dental practice. CONCLUSION There is a clear role for dental practitioners in addressing overweight and obesity among children, however further research is required to identify the most effective interventions to implement in dental practice.
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Affiliation(s)
- Amy R Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool 1871, Australia; Western Sydney University, Penrith 2751, Australia; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia.
| | - David George
- Western Sydney University, Penrith 2751, Australia
| | - Lucie M Ramjan
- Western Sydney University, Penrith 2751, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia; Centre for Applied Nursing Research (CANR), Liverpool 1871, Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool 1871, Australia; Western Sydney University, Penrith 2751, Australia; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia; University of Sydney, Camperdown 2050, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool 1871, Australia; Western Sydney University, Penrith 2751, Australia; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia; University of Sydney, Camperdown 2050, Australia
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24
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'A little bit offended and slightly patronised': parents' experiences of National Child Measurement Programme feedback. Public Health Nutr 2018; 21:2884-2892. [PMID: 29914583 DOI: 10.1017/s1368980018001556] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop a descriptive account of parents' experiences of written feedback from the National Child Measurement Programme (NCMP), based on primary data collected from semi-structured focus groups. DESIGN Four focus groups were held with a purposive sample of parents who had recently received written weight feedback from the NCMP in one local authority in England. Thematic data analysis was undertaken to develop a narrative of emergent themes regarding parents' experiences and the social influences shaping this.Setting/SubjectsThe population of interest was parents of 4- and 5-year-olds who had recently received written feedback from the NCMP. Eighteen parents participated and represented the full spectrum of categories provided in NCMP feedback (under-, healthy, over- and very overweight). RESULTS Participants often rejected overweight feedback as lacking in credibility and considered NCMP communication to be targeting parents other than themselves. Family and peers collaborated in the dismissal of overweight feedback, further legitimising participants' decision to disregard their child's overweight categorisation. CONCLUSIONS Our study provides an insight into parents' experiences of NCMP feedback, including how they relate to and understand that experience within a social context. By doing so, it makes a unique contribution to the existing body of evidence. Recommendations for practice based on the findings include further efforts to raise parents' and communities' awareness of childhood obesity, risks associated with childhood excess weight and obesity prevalence as a mainstream issue.
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