How training affects Australian paediatricians' management of obesity

Wake, Melissa; Campbell, Michele; Turner, Megan; Price, Anna; Sabin, Matthew A.; Davis, Elizabeth A.; Baur, Louise A.

doi:10.1136/archdischild-2012-301659

Cited by 23 publications

(22 citation statements)

References 28 publications

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“…Stakeholders indicated that they felt GPs and other health professionals were hesitant to raise the subject with parents or adolescents, most often due to a lack of referral options or lack of training to effectively manage these patients. This is consistent with existing literature [43,44]. …”

Section: Discussionsupporting

confidence: 94%

Barriers and enablers for participation in healthy lifestyle programs by adolescents who are overweight: a qualitative study of the opinions of adolescents, their parents and community stakeholders

et al. 2014

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BackgroundOverweight or obesity during adolescence affects almost 25% of Australian youth, yet limited research exists regarding recruitment and engagement of adolescents in weight-management or healthy lifestyle interventions, or best-practice for encouraging long-term healthy behaviour change. A sound understanding of community perceptions, including views from adolescents, parents and community stakeholders, regarding barriers and enablers to entering and engaging meaningfully in an intervention is critical to improve the design of such programs.MethodsThis paper reports findings from focus groups and semi-structured interviews conducted with adolescents (n?=?44), parents (n?=?12) and community stakeholders (n?=?39) in Western Australia. Three major topics were discussed to inform the design of more feasible and effective interventions: recruitment, retention in the program and maintenance of healthy change. Data were analysed using content and thematic analyses.ResultsData were categorised into barriers and enablers across the three main topics. For recruitment, identified barriers included: the stigma associated with overweight, difficulty defining overweight, a lack of current health services and broader social barriers. The enablers for recruitment included: strategic marketing, a positive approach and subsidising program costs. For retention, identified barriers included: location, timing, high level of commitment needed and social barriers. Enablers for retention included: making it fun and enjoyable for adolescents, involving the family, having an on-line component, recruiting good staff and making it easy for parents to attend. For maintenance, identified barriers included: the high degree of difficulty in sustaining change and limited services to support change. Enablers for maintenance included: on-going follow up, focusing on positive change, utilisation of electronic media and transition back to community services.ConclusionsThis study highlights significant barriers for adolescents and parents to overcome to engage meaningfully with weight-management or healthy lifestyle programs. A number of enablers were identified to promote ongoing involvement with an intervention. This insight into specific contextual opinions from the local community can be used to inform the delivery of healthy lifestyle programs for overweight adolescents, with a focus on maximising acceptability and feasibility.

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Section: Discussionsupporting

confidence: 94%

Barriers and enablers for participation in healthy lifestyle programs by adolescents who are overweight: a qualitative study of the opinions of adolescents, their parents and community stakeholders

et al. 2014

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“…One of the key problems with this approach has been that while paediatricians are at the forefront in the clinical management of obese children and adolescents, we have found that few (20%) feel they would be able to make a difference to an obese child's weight status (20%), or appropriately manage comorbidities (21e45%) [49]. This may be related to time pressures in general paediatric practice but also likely reflect the fact that paediatric obesity management has emerged as a new field of paediatric medicine and there are currently more questions than answers to fundamental questions that could lead to effective assessment and management.…”

Section: Current Approaches At Treatmentmentioning

confidence: 98%

Childhood obesity: Current and novel approaches

Sabin

Kieß

2015

Best Practice & Research Clinical Endocrinology & Metab

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“…Continuing professional development training will inevitably include aspects that learners may not perceive a pressing need for, attended with some reluctance and, even if acknowledged to be important, may be approached with variable engagement. The study of Wake and colleagues1 demonstrated a low recognition of the need for training, and in those who had specific training, little effect on diagnostic or management skills. Other important influences on learning are recognised to include factors such as the imminence of the learning need (‘ how soon will I need this information, or be tested on it?…”

mentioning

confidence: 99%

“…The paper from Wake et al 1 poses some uncomfortable questions looking at the impact of self-perceptions of competence and training on the management of obesity. This paper's importance is in considering clinical practice when addressing a significant health issue, and illustrates the difficulties around assessing the impact of training when tackling difficult and challenging issues.…”

mentioning

confidence: 99%