Health care professionals (HCPs) are feeling unable to tackle the growing problem of childhood obesity due to a lack of training and capacity, according to new research led by researchers from the University of Birmingham, UK.
The researchers conducted in-depth interviews with HCPs to understand their experiences of supporting families to tackle childhood obesity. Among key themes that were discussed, professionals shared their frustrations with a lack of time and training to support families, including limited availability for specialist services and lack of access to routinely collected data on children's weight. HCPs also shared their concerns about damaging trust by highlighting weight concerns about children, and many said that they were aware of cultural considerations when bringing up weight.
"This study brings a fresh awareness about the pressures that health care professionals face, including the limitations that they face in trying to provide preventative care for young people,” explained Miranda Pallan, Professor of Child and Adolescent Public Health in the Institute of Applied Health Research at the University of Birmingham and senior author of the paper. "Through the series of interviews with doctors, primary care nurses and school nurses, we have been able to see some clear barriers that prevent effective advice and support for families to tackle the growing epidemic of childhood obesity. While we should not expect doctors to be spending lots of time teaching families how to cook healthy, balanced meals, the study does highlight that health care professionals need more support and dedicated time to enable them to give practical advice and in some cases refer to more specialist services."
Thirteen GPs, seven primary care nurses (PNs) and 20 school nurses (SNs) participated in the study and 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).
"Everyone thinks it is everyone else's problem, no one is actually talking about the root causes with parents—which is predominantly food quality,” added Dr Ellen Fallows, a sessional GP in North Oxfordshire and Vice-President of The British Society of Lifestyle Medicine. “This is due to lack of time, knowledge and incentives for health care professionals. There are good and free training resources out there that really should be routinely provided as a first port of call. Childhood obesity is a really serious problem that could have lifelong implications and GPs could be ideally placed to lead the work to address it. However, without the training and a mandate to support people with self-care to address root causes, it will continue to be a challenge to make a meaningful difference for the many families who are looking for help."
Health care professionals also raised the issue of the use of BMI centiles for assessing weight problems in children. Different HCPs raised different concerns, with doctors and primary care nurses noting that they are less familiar with BMI centiles, and that BMI is not a good measure for younger children.
The findings were featured in the paper, ‘Supporting healthcare professionals to address child weight with parents: a qualitative study’, published in the British Journal of General Practice. To access this paper, please click here