Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, Postboks 422, 4604, Kristiansand, Norway.
Department of Children and Adolescents, Southern Norway Hospital, Kristiansand, Norway.
BMC Public Health. 2021 May 26;21(1):983. doi: 10.1186/s12889-021-11096-x.
Greater understanding about the prevention and treatment of overweight and obesity in preschool children within public health care is needed. This study assessed the impact of The First Steps module in routine primary health care including mapping of height/weight and diet followed by parental counselling of healthy habits on overweight and obesity in children aged 2 to 7 years. Further, we explored the experiences of public health nurses (PHNs) with the module.
Body weight and height obtained in 2014 and 2016 were extracted retrospectively for 676 children from the health records of children at 2, 4, or 6 years of age in five child health centers in Southern Norway. Sex- and age-adjusted body mass index (BMI) z-scores and weight status classifications were calculated according to the International Obesity Task Force reference values. Impact was assessed as change in mean BMI z-scores for children with under-, normal-, and overweight, respectively, and as proportion of children with overweight and obesity. In focus groups, PHNs described their experiences with the practical application of the module. Focus group transcripts were analyzed using Braun and Clarke's thematic analysis.
Mean BMI z-scores decreased from 2014 to 2016 in overweight children (- 0.26) and increased in children with under- (0.63) and normal weight (0.06), whereas the proportion of children with overweight and obesity was stable. PHNs believed that the module provides them with new tools that are useful for addressing the intricacies of childhood obesity. They described counseling sessions with families as "moving upstream in a river" and that overweight and obesity may be one of many complex challenges for these families.
Mean BMI z-score decreased in children with overweight during the 2 years after initiation of The First Steps module. PHNs considered the module as useful for addressing children's overweight and obesity, which was perceived as one of several complex challenges for most of these families. Specialist and evidence-based support is needed to address overweight and obesity in children in primary care. Further research should focus on integrating the issues relating to overweight and obesity within other family problems.
需要提高公共医疗保健领域对学龄前儿童超重和肥胖预防与治疗的理解。本研究评估了《第一步》模块在常规初级保健中的影响，包括对身高/体重和饮食进行映射，然后对父母进行健康习惯的咨询，以了解其对 2 至 7 岁儿童超重和肥胖的影响。此外，我们还探讨了公共保健护士（PHN）对该模块的经验。
从挪威南部五个儿童健康中心 2、4 或 6 岁儿童的健康记录中回顾性提取了 2014 年和 2016 年 676 名儿童的体重和身高数据。根据国际肥胖工作组的参考值，计算了性别和年龄调整后的体重指数（BMI）z 分数和体重状况分类。通过比较超重、正常和体重不足儿童的 BMI z 分数的均值变化，以及超重和肥胖儿童的比例，评估了影响。在焦点小组中，PHN 描述了他们在模块实际应用中的经验。使用 Braun 和 Clarke 的主题分析对焦点小组的转录进行了分析。
超重儿童的 BMI z 分数从 2014 年到 2016 年下降（-0.26），而体重不足和正常体重儿童的 BMI z 分数分别增加（0.63 和 0.06），而超重和肥胖儿童的比例保持稳定。PHN 认为该模块为他们提供了新的工具，有助于解决儿童肥胖的复杂性。他们将与家庭的咨询描述为“在河流上游移动”，并且超重和肥胖可能是这些家庭众多复杂挑战之一。
在启动《第一步》模块的 2 年后，超重儿童的 BMI z 分数均值下降。PHN 认为该模块有助于解决儿童超重和肥胖问题，他们认为这是这些家庭的众多复杂挑战之一。初级保健中需要专门的、基于证据的支持来解决儿童超重和肥胖问题。进一步的研究应侧重于将超重和肥胖问题纳入其他家庭问题中。
