Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK.
Psychological Sciences, University of Liverpool, UK.
Br J Health Psychol. 2018 Sep;23(3):701-722. doi: 10.1111/bjhp.12312. Epub 2018 Apr 26.
Childhood obesity is one of the most serious global public health challenges. However, obesity and its consequences are largely preventable. As parents play an important role in their children's weight-related behaviours, good communication between parents and health care professionals (HCPs) is essential. This systematic review provides a meta-synthesis of qualitative studies exploring the barriers and facilitators experienced by HCPs when discussing child weight with parents.
Searches were conducted using the following databases: MEDLINE (OVID), Psych INFO (OVID), EMBASE (OVID), Web of Knowledge and CINAHL. Thirteen full-text qualitative studies published in English language journals since 1985 were included. Included studies collected data from HCPs (e.g., nurses, doctors, dieticians, psychologists, and clinical managers) concerning their experiences of discussing child weight-related issues with parents. An inductive thematic analysis was employed to synthesize findings.
Emerging subthemes were categorized using a socio-ecological framework into intra/interpersonal factors, organizational factors, and societal factors. Perceived barriers and facilitators most commonly related to intra/interpersonal level factors, that is, relating to staff factors, parental factors, or professional-parent interactions. HCPs also attributed a number of barriers, but not facilitators, at the organizational and societal levels.
The findings of this review may help to inform the development of future weight-related communication interventions. Whilst intra/interpersonal interventions may go some way to improving health care practice, it is crucial that all stakeholders consider the wider organizational and societal context in which these interactions take place. Statement of contribution What is already known on the subject? Childhood obesity is one of the United Kingdom's most serious current public health challenges. Health care professionals are in a prime position to identify child weight issues during routine consultations. However, they often feel unable or unequipped to raise the topic and provide information on child weight management. What does this study add? To our knowledge, this is the first review to synthesize barriers and facilitators to discussing child weight. This review interprets key barriers and facilitators in the context of the socio-ecological model. Supports the development of interventions matched to the appropriate level of the socio-economic model.
儿童肥胖是全球最严重的公共卫生挑战之一。然而，肥胖及其后果在很大程度上是可以预防的。由于父母在孩子的体重相关行为中起着重要作用，因此父母与医疗保健专业人员（HCPs）之间的良好沟通至关重要。本系统综述提供了对定性研究的元综合，这些研究探讨了 HCPs 在与父母讨论儿童体重时所经历的障碍和促进因素。
使用以下数据库进行搜索：MEDLINE（OVID），Psych INFO（OVID），EMBASE（OVID），Web of Knowledge 和 CINAHL。纳入了自 1985 年以来以英文发表的 13 篇全文定性研究。纳入的研究从 HCPs（例如护士、医生、营养师、心理学家和临床经理）那里收集了有关他们与父母讨论与儿童体重相关问题的经验的数据。采用归纳主题分析对研究结果进行综合。
使用社会生态学框架将新兴的子主题分为人际因素、组织因素和社会因素。感知到的障碍和促进因素最常与人际因素相关，即与员工因素、父母因素或专业人员-父母互动有关。HCPs 还将一些障碍归因于组织和社会层面，但不是促进因素。
本综述的研究结果可能有助于为未来与体重相关的沟通干预措施的制定提供信息。虽然人际干预可能在一定程度上改善医疗保健实践，但所有利益相关者都必须考虑到这些互动发生的更广泛的组织和社会背景。
关于这个主题，已经有哪些已知的信息？儿童肥胖是英国目前最严重的公共卫生挑战之一。医疗保健专业人员在常规咨询期间处于识别儿童体重问题的最佳位置。然而，他们往往感到无法或没有能力提出这个话题，并提供有关儿童体重管理的信息。这项研究有什么新发现？据我们所知，这是第一项综合讨论儿童体重的障碍和促进因素的综述。本综述根据社会生态学模型解释了主要的障碍和促进因素。支持开发与社会经济模型的适当层次相匹配的干预措施。
