Implementing routine paediatric screening and weight management advice by clinicians: an evaluation

Abstract

To address childhood obesity, NSW Health has mandated that 70% of children and adolescents presenting to public health services have their height and weight measured. In South Western Sydney Local Health District (SWSLHD), the Growing Healthy Kids (GHK) program supported this initiative, and a range of strategies were implemented to meet this target. The aim of this thesis was to:

1. Evaluate the effectiveness of the GHK strategies to increase routine height and weight screening by healthcare professionals (HCPs) in SWSLHD.

2. Explore the facilitators and barriers to the implementation of the GHK strategies and the prevalence of weight bias among HCPs.

3. Explore the experience of the GHK program from the parents’ perspective.

Methods

Mixed methods study. The first study was a survey to evaluate the effectiveness of the implementation strategies from the perspective of HCPs. The second study used qualitative descriptive methods, to explore the experience from the parents' viewpoint.

Results

In the first study, 285 HCPs completed the survey (38% response rate). Implementation of routine screening practices varied among different HCPs and healthcare settings. Many barriers were identified, including lack of time and equipment and HCP’s perceptions and beliefs about obesity. Training, the provision of resources and equipment, and weight station set-up were the top three strategies that HCPs found to be most helpful.

In the second study, 24 parents were interviewed. The findings revealed that parents were willing to have their child's Body Mass Index status assessed and expected HCPs to raise the issue of weight. Parents often underestimated their child's weight status.

Conclusion

Measuring height and weight, as a first step to identifying and managing excess weight, is possible in healthcare settings. The strategies used were broadly effective, with education, training, provision of equipment and weight station set-up found to be most acceptable and useful.