Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
BMC Public Health. 2023 Sep 4;23(1):1704. doi: 10.1186/s12889-023-16527-5.
The prevalence of overweight and obesity in children is increasing, alongside increases in rates of children's anxiety and worry about their weight. In many countries children's weight is measured, and parents are made aware if a child has been classified as having overweight or obesity. However, many parents are concerned that raising their child's awareness of their weight, and talking to children about their weight could harm their wellbeing. The aim of this project was to develop guidance for parents on constructive ways to talk to children of primary school age about weight when they need to.
The project followed a mixed-methods design: Phase 1 involved the collation of evidence including (a) two previously published systematic literature reviews to identify the associations between parent-child weight talk, and broader health discussions, and children's wellbeing, (b) interviews with children, and (c) development and refinement of narrative messaging (previously published). In Phase 2 we developed a conceptual model and mapped primary findings to techniques and content within a draft guidance document for parents on talking to children about weight. Phase 3 involved a modified Delphi process with 29 stakeholders to refine and agree a final version.
An acceptable draft guidance was agreed following two stages of feedback from Delphi participants. Key areas for debate and adaptation included: encouraging discussion about health and growth with lesser focus on weight; finding ways to reduce stigma and perceptions of blame; emphasising a whole-family approach; inclusive representation of diversity among children and families.
Consensus on the content of guidance for parents on talking to children about weight was achieved through a process of evidence review and stakeholder and expert engagement. The next steps are to measure the impact of the resource on improving the experience of parents and children in communicating about weight.
儿童超重和肥胖的患病率在增加，同时儿童对体重的焦虑和担忧的比例也在增加。在许多国家，都会测量儿童的体重，如果孩子被归类为超重或肥胖，家长就会被告知。然而，许多家长担心提高孩子对自己体重的认识，以及与孩子谈论体重会对他们的健康造成伤害。本项目的目的是为家长制定指导意见，说明在需要时如何以建设性的方式与小学年龄的孩子谈论体重。
该项目采用混合方法设计：第 1 阶段包括证据收集，包括（a）两项先前发表的系统文献综述，以确定父母与孩子之间的体重谈话，以及更广泛的健康讨论与孩子的幸福感之间的关联，（b）对儿童进行访谈，以及（c）发展和完善叙事信息（先前发表）。在第 2 阶段，我们开发了一个概念模型，并将主要发现映射到一份关于父母与孩子谈论体重的指导文件草案中的技术和内容上。第 3 阶段涉及与 29 名利益相关者进行的修改后的 Delphi 流程，以完善和达成最终版本。
经过两轮 Delphi 参与者的反馈，达成了一份可接受的指导草案。有争议和需要调整的关键领域包括：鼓励讨论健康和成长，而较少关注体重；寻找减少污名和归咎感的方法；强调全家方法；包括儿童和家庭多样性的代表性。
通过证据审查和利益相关者和专家参与的过程，就父母与孩子谈论体重的指导内容达成了共识。下一步是衡量该资源对改善父母和孩子在沟通体重方面的体验的影响。
