Oral Presentation ANZOS Annual Scientific Meeting 2021

"It would put a rocket up me": a qualitative study of parent and clinician attitudes towards predicting childhood obesity in practice (#97)

Oliver J Canfell 1 2 3 , Robyn Littlewood 4 5 , Olivia Wright 6 , Jacqueline L Walker 6
  1. Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
  2. Digital Health Cooperative Research Centre, Australian Government, Sydney, NSW, Australia
  3. UQ Business School, The University of Queensland, St Lucia, QLD, Australia
  4. Health and Wellbeing Queensland, Australian Government, Brisbane, QLD, Australia
  5. Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
  6. School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia

Introduction: In Australia, almost one-in-four (24.9%) children live with overweight or obesity (OW/OB). A clinical prediction model (i-PATHWAY) has been developed by our research team to identify infants at-risk of developing future OW/OB. Prior to implementation of i-PATHWAY, the acceptability of predicting childhood OW/OB must be determined. This study aimed to: (1) Investigate the attitudes of clinicians and parents of infants (aged 0-2 years) towards predicting childhood OW/OB in practice and (2) Determine key language and phrasing to reduce judgment and maximise the acceptability of a model like i-PATHWAY. 

Methods: Cross-sectional and qualitative, comprising individual semi-structured interviews. The COREQ (Consolidated criteria for Reporting Qualitative research) checklist was followed. Participants were multidisciplinary paediatric clinicians (n=18) and parents of infants (n=13) (aged 0-2 years) recruited across networks of public hospital and health services in Queensland, Australia. Interviews were conducted by telephone at a children’s research centre in south-east Queensland. Interview data were analysed under the Framework Method using an inductive, thematic approach. 

Results: Five main themes were identified across both clinician and parent interview data: (1) Optimism for prevention and childhood obesity prediction (2) Parent dedication to child’s health (3) Adverse parent response to risk for childhood obesity (4) Clinical delivery (5) Language and phrasing for discussing weight and risk. Most participants were supportive of using a childhood OW/OB prediction tool in practice. Parents expressed dedication to their child’s health that superseded potential feelings of judgment or blame. When discussing weight in a clinical setting, the use of sensitive (i.e. ‘overweight’, ‘above average’, ‘growth’ versus ‘obesity’) and positive, health-focused language was mostly supported.  

Conclusion: Multidisciplinary paediatric clinicians and parents of infants generally accept the concept of predicting childhood OW/OB in practice in Queensland, Australia. Clinicians and policymakers can act now to implement sensitive communication strategies concerning weight and risk of obesity.