A randomized controlled trial examining an exam room poster to prompt communication about weight

Abstract

Background: Recognition of childhood weight status is important to the adoption of healthy lifestyle behaviours.Objectives: We assessed whether an exam room educational poster addressing weight and healthy lifestyle behaviours was acceptable to parents, prompted parentprovider communication or improved parental weight perception accuracy.Methods: In this multi-site randomized controlled trial, exam rooms were randomized to display the posters (English and Spanish) or not. Children ages 3 to 8 years (N = 965) attending well visits were weighed and roomed per usual clinic protocol.After the visit, parents completed a questionnaire assessing demographics, child weight status perceptions and whether they discussed weight status with provider or were shown growth charts. We used separate logistic regression analyses to examine associations between intervention status and: asking provider about child weight, being shown growth charts, and accuracy of weight perception, adjusting for covariates and clustering by exam room.Results: Of the parents who saw the poster, 97% liked seeing it and reported greater understanding of weight status visualization (96%) and healthy lifestyle behaviours (94%). Parents who saw the poster were more likely to report being shown a growth chart (OR 1.87, 95% 1.06, 3.30) but were not more likely to ask about their child's weight status nor accurately report their child's weight status.Conclusions: An educational exam room poster about healthy weight was wellreceived by parents and prompted providers to show the child's growth chart but did not prompt parent-initiated conversations about weight status nor improve parental weight perception accuracy. K E Y W O R D S communication, education, weight, weight perception

Human-centered designed communication tools for obesity prevention in early life

“…A poster also utilizes downtime while parents wait to see their provider. Previous work shows that posters can be successful pediatric public health education tools, ( Brown et al, Jul 2020 , Herrera et al, 2013 ) and may help facilitate conversations about pediatric weight. ( Brown et al, Jul 2020 ) We intend to examine whether our poster improves parent/provider communication about early life obesity prevention in future research.…”

Making Childhood Obesity a Priority: A Qualitative Study of Healthcare Professionals' Perspectives on Facilitating Communication and Improving Treatment

“…To make the "invisible" nature of excess weight concrete, the healthcare professionals in our study reported that they used growth charts to objectively compare the child's weight status to with a healthy weight reference population. Growth charts are useful and acceptable tools that professionals commonly use to improve counseling and facilitate behavior change (30). Therefore, these charts should be shown to parents before children develop obesity, to assist early prevention efforts.…”

The Smartphone-Assisted Intervention Improved Perception of Nutritional Status among Middle School Students

“…To our knowledge, there have been few studies primarily exploring the effect of intervention on perception of nutritional status among children or parents to date [ 15 , 16 , 17 ]. A randomized controlled trial in the USA assessed the effect of an educational intervention and revealed that parental perception of their children’s nutritional status was not improved [ 15 ]. Future work is necessary to elucidate the key factors affecting the accuracy of parental perception.…”

“…Most previous studies of observational or intervention types were focused on parental perception of their children’s nutritional status [ 12 , 13 , 14 , 15 ]. Our study is novel in its additional focus on students’ perception of their own nutritional status.…”

“…Inaccurate perception of children’s nutritional status was common on the basis of findings from two recent systematic reviews, which revealed that 50.7% (95% confidence interval (CI): 31.1%~70.2%) of parents underestimated the nutritional status of children who were overweight or obese, and 14.3% (95% CI: 11.7%~17.4%) of parents underestimated their own child’s normal weight [ 13 , 14 ]. However, few interventions have been specifically designed and tested to improve the accuracy of parental perception of their children’s nutritional status [ 15 , 16 , 17 ], and to date, no interventions have been directly focused on improving students’ perception of their own nutritional status.…”