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Addressing child and adolescent obesity management in Ireland: identifying facilitators and barriers in clinical
Farzana Ferdous1, Niamh Arthurs1, Louise Tully1
1Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Insights
Healthcare professionals in Ireland face significant barriers to managing child and adolescent obesity, including time constraints and lack of training. Addressing these issues is crucial for implementing the national Model of Care for overweight and obesity.
Area of Science:
- Public Health
- Healthcare Management
- Pediatrics
Background:
- Ireland's Model of Care for the Management of Overweight and Obesity requires stakeholder engagement for effective implementation.
- Child and adolescent obesity (CO) presents a significant public health challenge requiring improved healthcare services.
Purpose of the Study:
- To identify perceived barriers and facilitators in child and adolescent obesity management across diverse healthcare settings in the Republic of Ireland.
- To inform the implementation of the national Model of Care by understanding the current landscape of CO management.
Main Methods:
- An online cross-sectional survey was administered to 184 registered healthcare professionals (HPs) in the Republic of Ireland.
- The survey adhered to the Consolidated Framework for Implementation Research (CFIR) and included descriptive statistics and thematic analyses.
- Data collection occurred between September 2021 and May 2022.
Main Results:
- A majority of surveyed HPs (91%) were female; 54% conducted growth monitoring, and 32.6% diagnosed paediatric/adolescent obesity.
- Significant barriers included insufficient time (31.5%), lack of adequate resources (49%), limited access to anthropometric tools (10%), and a lack of paediatric obesity training (61%).
- Identified facilitators and barriers mapped to CFIR included time, training, professional competency, resources, and referral protocols.
Conclusions:
- Findings highlight critical implementation gaps in child and adolescent obesity management within Ireland's health system.
- The study provides actionable insights to guide the implementation of the Model of Care.
- Results will inform subsequent qualitative research to prioritize interventions for improving obesity management.
Background:
Ireland's Model of Care for the Management of Overweight and Obesity outlines a plan for treating adolescent and child obesity (CO). However, engagement with key stakeholders is required to support its implementation and improve health services.
Aim:
This study aims to map the perceived barriers and facilitators related to CO management across healthcare settings, professional disciplines, and regions in the Republic of Ireland (ROI).
Materials And Methods:
An online cross-sectional survey of registered healthcare professionals (HPs), designed to adhere to the Consolidated Framework for Implementation Research (CFIR), was co-developed by a project team consisting of researchers, healthcare professionals, and patient advocates. The survey was pilot tested with project stakeholders and distributed online to professional groups and via a social media campaign, between September 2021 and May 2022, using "SurveyMonkey." Data were summarised using descriptive statistics and thematic analyses. Themes were mapped to the CFIR framework to identify the type of implementation gaps that exist for treating obesity within the current health and social care system.
Results:
A total of 184 HPs completed the survey including nurses (18%), physicians (14%), health and social care professionals (60%), and other HPs (8%). The majority were female (91%), among which 54% reported conducting growth monitoring with a third (32.6%) giving a diagnosis of paediatric/adolescent obesity as part of their clinical practice. Nearly half (49%) of the HPs reported having the resources needed for clinical assessment. However, 31.5% of the HPs reported having enough "time," and almost 10% of the HPs reported having no/limited access to suitable anthropometric measurement tools. Most HPs did not conduct obesity-related clinical assessments beyond growth assessment, and 61% reported having no paediatric obesity training. CFIR mapping identified several facilitators and barriers including time for clinical encounters, suitable materials and equipment, adequate training, perceived professional competency and self-efficacy, human equality and child-centredness, relative priorities, local attitudes, referral protocols, and long waiting times.
Conclusions:
The findings provide actionable information to guide the implementation of the Model of Care for the Management of Overweight and Obesity in Ireland. Survey findings will now inform a qualitative study to explore implementation barriers and facilitators and prioritise actions to improve child and adolescent obesity management.
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