Supporting healthcare professionals to address child weight with parents: a qualitative study

Abstract

Background: Primary care and community healthcare professionals (HCP) are well placed to discuss child excess weight with parents and support them to make changes. However, HCPs have concerns about doing this. There is a need to understand the factors that influence HCPs in undertaking these activities to inform strategies to support them. Aim: To explore with HCPs working in primary care and community settings their experiences of having conversations about child weight with parents, and the factors that create barriers or facilitate them to have these conversations. Design and setting: A qualitative study with General Practitioners (GP), Primary Care Nurses (PN), and School Nurses (SN) in England. Method: GPs and PNs were recruited to participate in semi-structured interviews. SNs from a community healthcare NHS trust were recruited to participate in focus groups. Vignettes were used to stimulate discussion. Data were analysed guided by the Framework approach. Results: 13 GPs, 7 PNs, and 20 SNs participated. Identified barriers included structural, HCP-related and parent/family-related factors. Facilitating factors for having conversations with parents about child excess weight included structural changes (e.g. dedicated appointments, access to weight assessment data, joined up working across agencies), specific approaches adopted by HCPs, and enhancing HCPs’ skills (general and weight management-related) and knowledge of child weight management services. Conclusion: A range of barriers exist to HCPs addressing child excess weight with parents in primary care and community settings. Actions to effect structural changes and support HCPs in developing relevant knowledge and skills are required to overcome these.