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Proactive Assessment of Obesity Risk during Infancy (ProAsk): a qualitative study of parents' and professionals'
Jennie Rose1, Cris Glazebrook2, Heather Wharrad3
1Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road Campus, Cambridge, England. Jennie.Rose@anglia.ac.uk.
Insights
This study explored parents' and health professionals' experiences with the Proactive Assessment of Obesity Risk during Infancy (ProAsk) mHealth intervention. While engaging, biases hinder targeting infants most at risk of obesity.
Area of Science:
- Public Health
- Pediatrics
- Digital Health
Background:
- Childhood obesity is a major public health concern requiring early intervention.
- The Proactive Assessment of Obesity Risk during Infancy (ProAsk) is a novel mHealth intervention.
- ProAsk aims to assess infant overweight risk and motivate parental behavior change.
Purpose of the Study:
- To explore parents' and health professionals' experiences with ProAsk's risk communication and behavior change components.
- To understand user engagement and challenges with the mHealth intervention.
Main Methods:
- Feasibility study conducted in four economically deprived UK localities.
- 66 parents and 22 health visitors (HVs) participated.
- Thematic analysis of interviews with 12 parents and 15 HVs.
Main Results:
- Participants found ProAsk engaging due to its interactivity and visual presentation.
- Health visitors unfamiliar with technology received support from parents.
- Resistance to targeting infants at highest risk was observed due to cognitive and motivational biases.
Conclusions:
- The mHealth intervention engaged parents, promoting ownership of strategies to reduce infant overweight risk.
- Cognitive and motivational biases impede effective risk communication and targeted intervention delivery.
Background:
Prevention of childhood obesity is a public health priority. Interventions that establish healthy growth trajectories early in life promise lifelong benefits to health and wellbeing. Proactive Assessment of Obesity Risk during Infancy (ProAsk) is a novel mHealth intervention designed to enable health professionals to assess an infant's risk of future overweight and motivate parental behaviour change to prevent childhood overweight and obesity. The aim of this study was to explore parents' and health professionals' experiences of the overweight risk communication and behaviour change aspects of this mHealth intervention.
Methods:
The study was conducted in four economically deprived localities in the UK. Parents (N = 66) were recruited to the ProAsk feasibility study when their infant was 6-8 weeks old. Twenty two health visitors (HVs) used a hand-held tablet device to deliver ProAsk to parents when their infants were 3 months old. Parents (N = 12) and HVs (N = 15) were interviewed when infants in the study were 6 months old. Interview data were transcribed and analysed thematically using an inductive, interpretative approach.
Results:
Four key themes were identified across both parent and health visitor data: Engaging and empowering with digital technology; Unfamiliar technology presents challenges and opportunity; Trust in the risk score; Resistance to targeting. Most participants found the interactivity and visual presentation of information on ProAsk engaging. Health visitors who were unfamiliar with mobile technology drew support from parents who were more confident using tablet devices. There was evidence of resistance to targeting infants at greatest risk of future overweight and obesity, and both parents and health visitors drew on a number of reasons why a higher than average overweight risk score might not apply to a particular infant.
Conclusions:
An mHealth intervention actively engaged parents, enabling them to take ownership of the process of seeking strategies to reduce infant risk of overweight. However, cognitive and motivational biases that prevent effective overweight risk communication are barriers to targeting an intervention at those infants most at risk.
Trial Registration:
NCT02314494 . Date registered 11th December 2014.