Communicating with children and families about obesity and weight‐related topics: a scoping review of best practices

Abstract

Despite agreement on a number of guiding principles, evidence-based weight-related communication best practices are lacking. Rigorous, empirical evaluations of communication approaches are urgently required, especially those that include children's perspectives.

“Fat is really a four‐letter word”: Exploring weight‐related communication best practices in children with and without disabilities and their caregivers

“…Stakeholder involvement is also key when developing best practices (Best, Hiatt, & Norman, ; Kastner et al, ), although most synthesis studies such as scoping reviews skip this important step (Levac et al, ). Our study therefore “brings to life” the findings in our previous scoping review (McPherson, Hamilton, et al, ) and highlights the recommendations that are most salient for children and caregivers.…”

“…Caregivers endorsed many evidence‐based recommendations from the scoping review of weight‐related communication (McPherson, Hamilton, et al, ), although empirical evaluations of recommended approaches are still required. Participants' experiences show that there is much still to be done in implementing weight‐related communication best practices into clinical care.…”

“…To this end, we recently completed a comprehensive scoping review to identify and summarize the available evidence related to best practices in weight‐related communication between HCPs, children, and their parents (McPherson, Hamilton, et al, ). Despite study heterogeneity, some guiding principles were identified (see Figure ), although perspectives of children themselves regarding weight‐related communication preferences were sparse, and no literature included children with disabilities, despite their high obesity risk (Rimmer, Yamaki, Davis, Wang, & Vogel, ).…”

Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight‐Related Topics in Healthcare Consultations

“…Important components of therapeutic partnerships for participants included reciprocity, negotiation of mutually accepted goals, respect, and a shared understanding of the complexity of the children's lives which align with understandings of therapeutic relationships more broadly (e.g., Ridd et al, ). When considering communication between HCPs and children specifically about weight‐related topics, in the face of a lack of unequivocal best practices, some guiding principles identified in a recent scoping review (McPherson et al, ) could usefully be considered: for example, using a strengths‐based approach may promote better engagement and motivation. Strength‐based approaches move beyond the traditional “deficit” model and instead promote active collaboration between HCPs, caregivers and children (Tyler & Horner, ).…”

“…Yet, despite HCPs potential to enhance the well‐being needs of their patients, research among typically developing children (McPherson, Swift, et al, ) and children with disabilities (McPherson et al, ) suggest that HCPs often do not address weight‐related issues. Although there is an increasing body of literature identifying some of the barriers HCPs experience discussing weight‐related issues with typically developing children (McPherson et al, ), there is a dearth of evidence‐based recommendations regarding best practices for promoting positive conversations (McPherson et al, ). This lack of evidence is even more complicated for children with ASD who present weight‐related challenges that HCPs might not be familiar with, such as weight gain associated with antipsychotic medications, caregiver practices around feeding and routine management (Davison & Birch, ), family member psycho‐social well‐being (Abbeduto et al, ), difficulties with communication, along with social interaction and behavior management challenges (American Psychiatric Association, ).…”