Implementation of Child Healthy Weight Guidelines in the Dental Setting: A Pilot Study

There has been an increasing prevalence of childhood overweight and obesity worldwide and locally, with a quarter of Australian children now considered overweight. To address this, the New South Wales government in Australia released guidelines calling for all public dental services to identify children above a healthy weight and refer them to appropriate services. This study was part of a larger study that aimed to codesign and pilot implementation strategies to facilitate the translation of these guidelines into dental staff's practice.

A pre-post-test design was used to evaluate the strategies across two health districts in NSW. Strategies were codesigned by dental staff and parents of patients and included linguistically appropriate resources; discharge summaries from referral pathways; refresher training; involvement of dental assistants; templates for longitudinal BMI measures and growth assessment flyers for patients. A validated questionnaire measuring intention to engage in the guidelines and self-reported practice was distributed to interested staff before and after the delivery of strategies (2019-2022). Data describing dental staff's' actual practices over this time were also retrieved from patient information management systems. Descriptive and inferential statistics were used to assess the study outcomes and any differences across districts (n = 16).

There was no improvement in behavioural determinants of providing a growth assessment as indicated by the overall intention to engage in Children's Healthy Weight guideline (iCHEW) scale scores, however attitude scores had the largest observed improvement (from 30.1 to 35.2) and this was most pronounced in District 2 (27.2-34.3). A significant improvement in adherence to children's healthy weight guidelines was also seen in District 2 (increase of 20.54%, 95% CI 14.09-27.44). In District 1, children had 1.5 times the odds of receiving a growth assessment if they were treated by a dental officer (OR = 1.54; 95% CI 1.00-1.72). Conversely, children in District 2 had significantly lower odds of receiving a growth assessment if they were treated by a dental officer (OR = 0.203; 95% CI 0.12-0.35) or if they were treated at a satellite clinic (OR = 0.572; 95% CI 0.45-0.73).

Dental staff can play a key role in addressing childhood overweight and obesity, although this can be challenging. The findings suggested some improvements in behavioural determinants and self-reported behaviours following supportive strategies. Further research to confirm these findings using larger sample sizes is recommended.