Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham.
Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich.
Br J Gen Pract. 2024 May 30;74(743):e417-e425. doi: 10.3399/BJGP.2023.0238. Print 2024 Jun.
Primary care and community healthcare professionals (HCPs) are well placed to discuss child excess weight with parents and support them to make changes. However, HCPs have concerns about addressing this issue. There is a need to understand the factors that influence HCPs in initiating these conversations to inform strategies to support them.
To explore with HCPs, working in primary care and community settings, their experiences of having conversations about child weight with parents, and the factors that create barriers or facilitate them to have these conversations.
A qualitative study with GPs, primary care nurses (PNs), and school nurses (SNs) in England.
GPs and PNs were recruited to participate in semi-structured interviews. SNs from a community healthcare NHS trust were recruited to participate in focus groups. Vignettes were used to stimulate discussion. Data were analysed guided by the Framework approach.
Thirteen GPs, seven PNs, and 20 SNs participated. 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).
A range of barriers exist to HCPs addressing child excess weight with parents in primary care and community settings. Actions to effect structural changes and support HCPs in developing relevant knowledge and skills are required to overcome these barriers.
初级保健和社区医疗保健专业人员(HCP)非常适合与父母讨论儿童超重问题,并为他们提供支持以进行改变。然而,HCP 在解决这个问题时存在一些顾虑。有必要了解影响 HCP 发起这些对话的因素,以便为他们提供支持的策略提供信息。
探索在初级保健和社区环境中工作的 HCP 与父母就儿童体重进行对话的经验,以及造成障碍或促进他们进行这些对话的因素。
在英格兰进行的一项针对全科医生、初级保健护士(PNs)和学校护士(SNs)的定性研究。
招募全科医生和 PNs 参加半结构化访谈。社区医疗 NHS 信托的 SNs 参加焦点小组。使用小插曲来激发讨论。数据分析由框架方法指导。
共有 13 名全科医生、7 名 PNs 和 20 名 SNs 参与了研究。在讨论中确定了三个主题,这些主题涉及 HCP 进行儿童超重对话的障碍:结构性和组织性障碍;HCP 相关障碍;以及父母或家庭相关障碍。为促进这些对话而确定的主题包括:结构性变化(例如,专用预约、获得体重评估数据、跨机构的联合工作);HCP 方法(例如,提供适当的饮食和身体活动建议);以及 HCP 的知识和技能(例如,增强 HCP 关于儿童体重管理服务的一般和体重管理相关技能和知识)。
在初级保健和社区环境中,HCP 解决儿童超重问题存在一系列障碍。需要采取行动进行结构性变革,并支持 HCP 发展相关知识和技能,以克服这些障碍。