Discussing overweight in children during a regular consultation in general practice: a qualitative study

Area of Science:

• Pediatrics
• General Practice
• Public Health

Background:

• Childhood overweight is a growing public health concern with long-term health implications.
• Dutch guidelines recommend general practitioners (GPs) address childhood obesity proactively.
• GPs report facing challenges in discussing this sensitive topic during consultations.

Purpose of the Study:

• To identify current barriers faced by Dutch GPs in discussing overweight in children aged 4-12.
• To assess the extent to which GPs discuss childhood overweight.
• To understand GPs' needs and suggestions for improvement.

Main Methods:

• A qualitative study using semi-structured in-depth interviews with Dutch GPs.
• Modified constant comparative method for thematic analysis of interview transcripts.
• Participants represented diverse demographic characteristics.

Main Results:

• Ten GPs participated, revealing four key themes: lack of presenting complaints, GP internal barriers, family background, and logistical issues.
• Major barriers included low consultation rates for these children, topic sensitivity (fear of reactions, impact on self-esteem), lack of established patient relationships, and time limitations.
• GPs expressed a need for practical tools to discuss overweight within limited consultation times.

Conclusions:

• Dutch GPs encounter substantial barriers when addressing childhood overweight.
• A lack of physical complaints in children aged 4-12 presents a novel challenge.
• Increased parental awareness and highlighting the supportive role of primary care are suggested strategies.