Talking About Weight With Families—Helping Health Care Professionals Start the Conversation: A Nonrandomized Controlled Trial

Abstract

Health care professionals (HCPs) and trainees feel ill-equipped to discuss weight-related issues with children and their families. A whiteboard video for HCPs and trainees outlining strategies to communicate about weight was developed and evaluated. Seventy HCPs, including 15 trainees, participated in the baseline assessment and 39 repeated measures 4 to 6 months later. HCP self-efficacy for initiating conversations with overweight and underweight patients, measured immediately following the video, significantly improved from pre-video values ( Z = −5.6, P ≤ .001, and Z= −3.3, P = .001, respectively). Although improvements were not sustained 4 to 6 months later (overweight: P = .143, and underweight: P = .846), no significant decline was observed, suggesting retention of the skill. A majority of HCP respondents would recommend the video to a colleague and feel it will affect their practice. Thus, the present study suggests educational videos may be an effective tool for facilitating healthy weight-related conversations between HCPs and their pediatric patients.

Evaluation of a Pediatric Obesity Management Toolkit for Health Care Professionals: A Quasi-Experimental Study

“…Post-video and 4–6 months following the intervention, the majority of HCPs described that the videos had led to practice change in regard to addressing weight-related issues. This finding of a positive impact on clinical practice using a video intervention has been previously described and supported [ 21 ], and extends the findings of our previous work [ 26 ]. Concordant with this, the majority of respondents rated the video content highly, raising the possibility that they would return to these resources at a later time if needed.…”

“…Although baseline ratings for knowledge and self-efficacy were relatively high, it is notable that, with the exception of questions related specifically to the 5As, there was still a change in knowledge and self-efficacy immediately post-video. Baseline ratings for self-efficacy were higher than in previous studies [ 3 , 26 ], raising the possibility that HCPs’ confidence in treating pediatric patients with obesity may be improving, as previously suggested [ 33 ]. However, for certain aspects of care, such as “engaging patients and families in development of behavior-based management plans” and “assisting patients and families in addressing the drivers and barriers to weight management,” our findings indicate a need for further education and improvement.…”

“…This quasi-experimental design used a pre- and post-video evaluation, similar to our previous study [ 26 ], and a 4–6 month follow-up to assess if self-efficacy scores would be maintained in the short-term. The study was conducted at SickKids hospital in Toronto, Canada.…”

“…Although this resource is a helpful tool for HCPs, feedback from focus groups indicate that HCPs would like an expanded version with practical visuals of how a 5As framed encounter would occur in a busy office setting. Using best practices in education pedagogy and multimedia development principles, we previously developed an educational whiteboard video for HCPs outlining strategies to communicate about weight with children and their families, based on the first A (“Ask”) [ 26 ]. We found that HCPs’ self-reported self-efficacy for initiating conversations with patients with low and high body weights significantly improved immediately following the video, with no significant decline 4–6 months later, indicating skill retention [ 26 ].…”

Making Childhood Obesity a Priority: A Qualitative Study of Healthcare Professionals' Perspectives on Facilitating Communication and Improving Treatment

“…However, clinical practice alone does not improve communication skills, and when communication skills are lacking, practitioners usually avoid difficult conversations (38). Therefore, formal training is crucial in improving communication with families (40). In the present study, the respondents identified lack of training as a barrier to communicating with families.…”