Aicken, Catherine

Fildes, Alison

Llewellyn, Clare

Merriel, Samuel W D

Background One in five British children are overweight or obese when entering primary school but most parents fail to recognise child overweight. Health-care professionals are expected to manage childhood overweight, but initiating conversations with parents is difficult. The aim of this study was to inform the development of a visual and language toolbox to support health-care professionals in initiating sensitive conversations about weight with parents of overweight preschool children. Methods Three focus group discussions were conducted with health-care professionals (total n=29) recruited from general practices in London and Bristol, UK, and 15 semi-structured interviews were undertaken with parents of preschool children (&lt;5 years). Focus groups and interviews explored: barriers preventing conversations between health-care professionals and parents about children's overweight; the potential for existing visual body image scales to help parents put their child's weight in context; and preferred language for use in conversations about child weight. Interviews and focus groups were audio recorded, transcribed verbatim, and analysed using thematic analysis in a deductive top down approach based on predetermined themes explored in the focus groups and interviews. Findings Health-care professionals perceived parents as being unconcerned about child overweight; parents were apprehensive about health-care professionals criticising their parenting skills. Some health-care professionals did not consider child overweight to be their responsibility. General practitioners were reluctant to discuss weight with parents because of shortage of time, fear of damaging patient–practitioner relationships, and insufficient training; nurses were more willing. Both health-care professionals and parents were positive about the potential for body image scales to facilitate conversations, generally preferring scales based on three-dimensional body scans over artists' drawings. Parents thought that language used by health-care professionals needed to be clear and impactful, but not stigmatising—eg, overweight, very overweight (but not fat, heavy, or obese). Interpretation The findings suggest that a visual and language toolbox would be well received by parents and health-care professionals. Anatomically accurate preschool body image scales are needed for use in consultations. Practice nurses may be better placed than general practitioners to initiate conversations with parents. Health-care professionals should consider parents' conceptions of health and blame when conducting consultations, to encourage parental recognition of preschool overweight, with the ultimate aim of facilitating appropriate behaviour change. Funding This study is funded by a Cancer Research UK/Bupa Foundation Innovation award. The funders had no role in the writing of the abstract or the decision to submit it for publication

Explore Bristol Research

                          Fildes, A., Aicken, C., Merriel, S. W. D., & Llewellyn, C. (2017).Developing a communication toolbox for primary care practitioners to raisethe issue of weight with parents of preschool children: a qualitative study. InPublic Health Science 2017 (pp. s38). (Lancet; Vol. 390, No. S3). LancetPublishing Group. https://doi.org/10.1016/S0140-6736(17)32973-2Peer reviewed versionLink to published version (if available):10.1016/S0140-6736(17)32973-2Link to publication record in Explore Bristol ResearchPDF-documentThis is the author accepted manuscript (AAM). The final published version (version of record) is available onlinevia Elsevier at https://www.sciencedirect.com/science/article/pii/S0140673617329732 . Please refer to anyapplicable terms of use of the publisher.University of Bristol - Explore Bristol ResearchGeneral rightsThis document is made available in accordance with publisher policies. Please cite only the publishedversion using the reference above. Full terms of use are available:http://www.bristol.ac.uk/pure/about/ebr-terms  Developing a communication toolbox for primary care practitioners to raise the issue of weight with parents of preschool children: A qualitative study  Dr Alison Fildes PhD*1,2, Ms Catherine Aicken MSc2, Dr Samuel WD Merriel MSc3, Dr Clare Llewellyn PhD2 1School of Psychology, University of Leeds, Leeds, UK 2Department of Behavioural Science & Health, University College London, London, UK 3Centre for Academic Primary Care, University of Bristol, Bristol, UK  *Dr Alison Fildes, University Academic Fellow, School of Psychology, University of Leeds, Woodhouse Lane, Leeds LS2 9JT. a.fildes@ucl.ac.uk   Background: One-in-five British children are overweight or obese when entering primary school but most parents fail to recognise child overweight. Health care professionals (HCPs) are expected to manage childhood overweight, but initiating conversations with parents is difficult. The aim of this study was to inform the development of a visual and language 'toolbox' to support HCPs in initiating sensitive conversations about weight with parents of overweight preschool children. Methods: Three focus group discussions were conducted with HCPs (combined n=29) recruited from GP practices in London and Bristol, and fifteen semi-structured interviews were undertaken with parents of preschool children (under 5 years). Focus groups and interviews explored: (i) barriers preventing conversations between HCPs and parents about children’s overweight; (ii) the potential for existing visual body image scales to help parents put their child’s weight ‘in context’; (iii) preferred language for use in conversations about child weight. Interviews and focus groups were audio recorded, transcribed verbatim and analysed using thematic analysis in a deductive ‘top down’ approach based on predetermined themes explored in the focus groups and interviews. Findings: HCPs perceived parents as unconcerned about child overweight; parents were apprehensive about HCPs criticising their parenting skills.  Some HCPs did not consider child overweight their responsibility. GPs were reluctant to discuss weight with parents because of shortage of time, fear of damaging patient-practitioner relationships and insufficient training; nurses were more willing.  Both HCPs and parents were positive about the potential for body image scales to facilitate conversations, generally preferring scales based on 3D body scans over artists’ drawings. Parents considered language used by HCPs needed to be clear and impactful, but non-stigmatising, e.g. overweight, very overweight (and not: fat, heavy or obese).   Interpretation: Findings suggest a visual and language toolbox would be well-received by parents and HCPs. Anatomically accurate computer generated preschool body image scales are needed for use in consultations. Practice nurses may be better placed than GPs to initiate conversations with parents. HCPs should consider parents’ conceptions of health and blame when conducting consultations, to encourage parental recognition of preschool overweight, with the ultimate aim of facilitating appropriate behaviour change.    Funding: This study is funded by a Cancer Research UK/BUPA Foundation Innovation award. The funders had no role in the writing of the abstract or the decision to submit it for publication. Contributors: AF, CL and SM designed the study. AF, CL and CA conducted the data collection and analysis. AF wrote the Abstract with input from CL, CA and SM. All authors have seen and approved the final version of the Abstract for publication  Conflicts of interest: We declare that we have no conflicts of interest  

Developing a communication toolbox for primary care practitioners to raise the issue of weight with parents of preschool children:a qualitative study

Alison Fildes

Catherine Aicken

Samuel W D Merriel

Clare Llewellyn

Crossref

The Lancet

Developing a communication toolbox for primary care practitioners to raise the issue of weight with parents of preschool children: a qualitative study

The University of Manchester - Institutional Repository

https://research-information.bris.ac.uk/files/143721645/TFT_Lancet_Abstract_1.pdf

Developing a communication toolbox for primary care practitioners to raise the issue of weight with parents of preschool children:a qualitative study

Abstract

Similar works

Full text

Available Versions

Explore Bristol Research

Crossref

The University of Manchester - Institutional Repository