Supporting healthcare professionals to address child weight with parents: a qualitative study

Miranda Pallan; Frances Mason; Helen M Parretti; Peymané Adab; Sally Abbott; Kate Jolly

doi:10.3399/BJGP.2023.0238

Supporting healthcare professionals to address child weight with parents: a qualitative study

Br J Gen Pract. 2024 May 30;74(743):e417-e425. doi: 10.3399/BJGP.2023.0238. Print 2024 Jun.

Authors

Miranda Pallan¹, Frances Mason¹, Helen M Parretti², Peymané Adab¹, Sally Abbott³, Kate Jolly¹

Affiliations

¹ Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham.
² Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich.
³ Research Centre for Healthcare and Communities, Institute for Health and Wellbeing, Coventry University, Coventry; Department of Dietetics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry.

Abstract

Background: Primary care and community healthcare professionals (HCPs) are well placed to discuss child excess weight with parents and support them to make changes. However, HCPs have concerns about addressing this issue. There is a need to understand the factors that influence HCPs in initiating these conversations to inform strategies to support them.

Aim: To explore with HCPs, working in primary care and community settings, their experiences of having conversations about child weight with parents, and the factors that create barriers or facilitate them to have these conversations.

Design and setting: A qualitative study with GPs, primary care nurses (PNs), and school nurses (SNs) in England.

Method: GPs and PNs were recruited to participate in semi-structured interviews. SNs from a community healthcare NHS trust were recruited to participate in focus groups. Vignettes were used to stimulate discussion. Data were analysed guided by the Framework approach.

Results: Thirteen GPs, seven PNs, and 20 SNs participated. The following three themes were identified regarding barriers to HCPs having conversations about child excess weight: structural and organisational; HCP related; and parent or family related. The themes identified for the factors that facilitate these conversations were: structural changes (for example, dedicated appointments, access to weight assessment data, joined-up working across agencies); HCP approaches (for example, providing appropriate dietary and physical activity advice); and HCP knowledge and skills (for example, enhancing HCPs' general and weight management-related skills and knowledge of child weight management services).

Conclusion: A range of barriers exist to HCPs addressing child excess weight with parents in primary care and community settings. Actions to effect structural changes and support HCPs in developing relevant knowledge and skills are required to overcome these barriers.

Keywords: child; general practice; paediatric obesity; primary health care; qualitative research; school nursing.

MeSH terms

Adult
Attitude of Health Personnel
Child
Communication
England
Female
Focus Groups
Humans
Male
Parents* / psychology
Pediatric Obesity* / prevention & control
Primary Health Care
Professional-Family Relations
Qualitative Research*
School Nursing