Oral Presentation ANZOS Annual Scientific Meeting 2021

i-PATHWAY: A co-design of clinical decision-making guides to support a childhood obesity prediction tool in practice (#94)

Leila Fathi 1 , Jacqueline Walker 1 2 , Robyn Littlewood 1 2 , Olivia Wright 1 , Oliver Canfell 1
  1. the University of Queensland, Brisbane, QLD, Australia
  2. Health and Wellbeing Queensland, Brisbane, QLD, Australia

Objective 

This study’s objective was to co-design two clinical resources – a User and Clinical Actions guide to support the implementation of a childhood obesity prediction tool (i- PATHWAY) in an Australian healthcare setting. i-PATHWAY uses six routinely collected risk factors at age 1 year to predict childhood obesity at age 8-9 years with 74% accuracy.

 

Methods 

Multidisciplinary clinicians (n 3) and caregivers of infants (aged 0-2 years) (n 3) (end-users) were recruited during COVID-19 restrictions in 2020 and participated in two iterative, semi-structured virtual focus groups to co-design the guides. Co-design was actioned across three user-centred, participatory phases, contextualised to the study objective: (1) Exploring clinical dynamics of clinicians and caregivers; (2) Assessment of end-user needs; (3) Concept development of clinical resources. Focus groups were recorded and transcribed verbatim. Thematic analysis was conducted using the Framework Method to inductively identify themes.

 

Results 

Four main themes were identified that directly informed co-design of the User and Clinical Actions guides. Clinicians and caregivers require unique, targeted language approaches when communicating obesity risk; standardisation of language, resource design and clinical delivery of i-PATHWAY is necessary; resource conciseness will enhance acceptability; clinician phraseology must be people-first, positive, non-judgmental and evidence-based. Digital concepts of the User and Clinical Actions resources were then created. The User guide provides sequential, pragmatic scenarios and language recommendation to guide sensitive clinical use of i-PATHWAY. The Clinical Actions guide is a simple clinical decision pathway to inform preventive action for infants at-risk of developing future obesity.

 

Conclusions 

A User and Clinical Actions guide were co-designed with end-users. Implementation of these clinical resources in conjunction with i-PATHWAY in practice can enhance acceptability of predicting childhood obesity and improve clinical preventive decision-making. Successful implementation of i-PATHWAY may contribute to a reduction in childhood obesity prevalence in the long-term in Australia.