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Published on: September 19, 2019
Improving child weight management uptake through enhanced National Child Measurement Programme parental feedback
1PHE Behavioural Insights Team (PHE BI), Research, Translation & Innovation Division, 6th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, United Kingdom of Great Britain and Northern Ireland.
Insights
Enhanced National Child Measurement Programme (NCMP) letters significantly increased children's weight management service enrollment. These informative letters, providing weight status feedback, improved parental engagement in pediatric weight interventions.
Area of Science:
- Public Health
- Pediatrics
- Behavioral Science
Background:
- Childhood obesity is a significant public health concern requiring effective intervention strategies.
- The National Child Measurement Programme (NCMP) identifies overweight and obese children but lacks robust follow-up mechanisms.
- Parental engagement is crucial for successful pediatric weight management service uptake.
Purpose of the Study:
- To evaluate the effectiveness of enhanced NCMP letters in improving children's weight management service enrollment.
- To assess the impact of tailored feedback and resources on parental decision-making regarding weight management.
- To investigate the influence of social norms and visual aids in promoting service utilization.
Main Methods:
- A pragmatic, cluster randomized controlled trial involving 2642 children aged 10-11 years across three English counties.
- Intervention group received enhanced NCMP letters with visual tools, social norms, and booking forms for very overweight children.
- Control group received standard NCMP letters; primary outcome was weight management service enrollment.
Main Results:
- Intervention group showed significantly higher enrollment (4.33%) versus control (2.19%) (OR=2.08, p=.008).
- Contact with services (4.80% vs. 2.41%) and attendance (1.89% vs. 1.02%) also increased in the intervention group.
- Adjusted analyses confirmed significant improvements in enrollment (AOR=2.48, p=.001) and contact (AOR=2.46, p<.001).
Conclusions:
- Theoretically informed, enhanced NCMP letters are an effective strategy to boost enrollment in pediatric weight management services.
- Providing clear weight status feedback and accessible resources can overcome barriers to service uptake.
- This intervention represents a scalable approach to improve public health outcomes for childhood obesity.
Abstract:
This single-blind, pragmatic, cluster randomised controlled trial aims to investigate uptake of children's weight management services in response to enhanced National Child Measurement Programme (NCMP) letters providing weight status feedback to parents in three English counties in 2015. Parents of 2642 overweight or very overweight (obese) children aged 10-11 years received an intervention or control letter informing them of their child's weight status. Intervention letters included (i) a visual tool to help weight status recognition, (ii) a social norms statement, and for very overweight children, (iii) a prepopulated booking form for weight management services. The primary outcome was weight management service enrolment. Additional outcome measures included attendance at and contact made with weight management services, and a number of self-report variables. A small effect was observed, with intervention parents being significantly more likely to enrol their children in weight management services (4.33% of Intervention group) than control parents (2.19% of Control group) in both unadjusted (OR = 2.08, p = .008) and adjusted analyses (AOR = 2.48, p = .001). A similar picture emerged for contact with services (4.80% Intervention vs. 2.41% Control; OR = 2.10, p = .003; AOR = 2.46, p < .001) and attendance at services, although group differences in the latter measure were not significant after corrections for multiple comparisons (1.89% Intervention vs. 1.02% Control; AOR = 2.11, p = .047). No effects were found on self-report variables. Theoretically informed weight status feedback letters appear to be an effective strategy to improve enrolment in paediatric weight management services.
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