As part of a NSW Health state wide initiative to address childhood obesity, all children aged 0-16 years who come into contact with a NSW Health clinical service should have their height and weight measured and recorded every 90 days. In conjunction with mandated growth assessments, clinicians are expected to advise the family of the child’s weight status, assist the family by providing a brief lifestyle intervention and arrange referrals to appropriate services.
This qualitative study explored the experiences and perceptions of a range of clinicians who are implementing routine growth assessments in clinical services in the Mid North Coast Local Health District.
Online focus groups were conducted in November 2020. Some clinical settings were underrepresented in focus groups so health professionals from these settings were purposefully recruited to participate in semi-structured interviews to add their perspective. Focus groups and interviews were video recorded, transcribed and manually coded to identify emergent themes.
Seventeen allied health clinicians and four nurses from inpatient, outpatient and community health settings participated in the focus groups. Five clinicians including an emergency physician, paediatric NUM, out of home care coordinator, refugee health manager and mental health manager participated in semi structured interviews.
Clinicians’ perception of the mandate and their clinical practice depended on whether they believed compliance compromised or complemented patient care. This belief was influenced by interpersonal qualities, professional identity, clinical workflow and broader factors in the health service ecosystem. These key themes could act as barriers or facilitators depending on the clinician and the setting.
This work will inform practice based recommendations about how future interventions can address these factors to better support health professionals and the health service ecosystem to address childhood obesity in clinical settings.