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Interventions for prevention of childhood obesity in primary care: a qualitative study
Nicole Bourgeois1, Paula Brauer1, Janis Randall Simpson1
1Department of Family Relations and Applied Nutrition (Bourgeois, Brauer, Randall Simpson, Haines), University of Guelph, Guelph, Ont.; Family Practice Health Centre (Bourgeois, Kim), Women's College Hospital; Department of Family and Community Medicine (Kim), University of Toronto, Toronto, Ont.
Insights
Primary care clinicians and parents see potential for childhood obesity prevention programs, despite implementation barriers. Future pilot studies are recommended to refine strategies for integrating these interventions into well-child visits.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Childhood obesity prevention is a public health priority requiring effective primary care interventions.
- Parent perspectives are crucial but underrepresented in current obesity prevention literature.
- Team-based primary care settings offer opportunities for early intervention.
Purpose of the Study:
- To explore primary care clinician and parent views on implementing childhood obesity prevention interventions.
- To identify facilitators and barriers to intervention implementation in primary care.
- To inform the development of effective obesity prevention strategies for young children.
Main Methods:
- Focus groups with 40 interprofessional primary care clinicians.
- Interviews with 26 parents of children aged 2-5 years.
- Directed content analysis of transcribed qualitative data.
Main Results:
- Key barriers include gaps in well-child care, time constraints, and topic sensitivity.
- Clinician-patient trust and existing relationships facilitate implementation.
- Participants desired separate programs for parents and children, covering general parenting and obesity.
Conclusions:
- Clinicians and parents are interested in primary care-based obesity prevention interventions despite identified challenges.
- Further research, including pilot studies, is needed to determine feasible implementation strategies.
- Addressing both general parenting and obesity-specific behaviors is recommended.
Background:
Preventing childhood obesity is a public health priority, and primary care is an important setting for early intervention. Authors of a recent national guideline have identified a need for effective primary care interventions for obesity prevention and that parent perspectives on interventions are notably absent from the literature. Our objective was to determine the perspectives of primary care clinicians and parents of children 2-5 years of age on the implementation of an obesity prevention intervention within team-based primary care to inform intervention implementation.
Methods:
We conducted focus groups with interprofessional primary care clinicians (n = 40) and interviews with parents (n = 26). Participants were asked about facilitators and barriers to, and recommendations for implementing a prevention program in primary care. Data were recorded and transcribed, and we used directed content analysis to identify major themes.
Results:
Barriers existed to addressing obesity-related behaviours in this age group and included a gap in well-child primary care between ages 18 months and 4-5 years, lack of time and sensitivity of the topic. Trust and existing relationships with primary care clinicians were facilitators to program implementation. Offering separate programs for parents and children, and addressing both general parenting topics and obesity-related behaviours were identified as desirable.
Interpretation:
Despite barriers to addressing obesity-related behaviours within well-child primary care, both clinicians and parents expressed interest in interventions in primary care settings. Next steps should include pilot studies to identify feasible strategies for intervention implementation.
