Conducting a psychosocial and lifestyle assessment as part of an integrated care approach for childhood obesity: experiences, needs and wishes of Dutch healthcare professionals

Abstract

Background The causes and consequences of childhood obesity are complex and multifaceted. Therefore, an integrated care approach is required to address weight-related issues and improve children’s health, societal participation and quality of life. Conducting a psychosocial and lifestyle assessment is an essential part of an integrated care approach. The aim of this study was to explore the experiences, needs and wishes of healthcare professionals with respect to carrying out a psychosocial and lifestyle assessment of childhood obesity. Methods Fourteen semi-structured interviews were conducted with Dutch healthcare professionals, who are responsible for coordinating the support and care for children with obesity (coordinating professionals, ‘CPs’). The following topics were addressed in our interviews with these professionals: CPs’ experiences of both using childhood obesity assessment tools and their content, and CPs’ needs and wishes related to content, circumstances and required competences. The interviews comprised open-ended questions and were recorded and transcribed verbatim. The data was analysed using template analyses and complemented with open coding in MAXQDA. Results Most CPs experienced both developing a trusting relationship with the children and their parents, as well as establishing the right tone when engaging in weight-related conversations as important. CPs indicated that visual materials were helpful in such conversations. All CPs used a supporting assessment tool to conduct the psychosocial and lifestyle assessment but they also indicated that a more optimal tool was desirable. They recognized the need for specific attributes that helped them to carry out these assessments, namely: sufficient knowledge about the complexity of obesity; having an affinity with obesity-related issues; their experience as a CP; using conversational techniques, such as solution-focused counselling and motivational interviewing; peer-to-peer coaching; and finally, maintaining an open-minded, non-stigmatizing stance and harmonizing their attitude with that of the child and their parents. Conclusions Alongside the need for a suitable tool for conducting a psychosocial and lifestyle assessment, CPs expressed the need for requisite knowledge, skills and attitudes. Further developing a supporting assessment tool is necessary in order to facilitate CPs and thereby improve the support and care for children with obesity and their families.

A Psychosocial And Lifestyle Assessment For Childhood Obesity: A Scoping Literature Review And Focus Groups With Healthcare Professionals

“…The extent to which HCPs feel that they are able to conduct a psychosocial and lifestyle assessment seems to be related to years of work experience, a nity with the issues relating to overweight and obesity, level of knowledge, con dence in one's own professional skills and the ability to adjust one's attitude to correspond to individual children and their parents (19). The role of these elements is well documented in the literature with regard to discussing a child's weight, as well as when referring children to treatment and obesity counselling (19,47,52). This is supported by the results of this study.…”

“…In a previous study, we examined a supporting assessment tool that CPs can use as a guide for obtaining information about factors that may contribute to the development and maintenance of obesity and obtaining a broad view of children and their family circumstances (18,19). In that study, we also identi ed several potential improvements to be made in the further development of the tool, including the addition of in-depth questions for assessing psychosocial factors, the inclusion of an instructional guide explaining how to use the assessment tool and the adaptation of the tool to make it more age-speci c (19). In addition, the CPs who were interviewed for that study expressed a need for more knowledge about the complexity of obesity and the development of ageappropriate visual materials for conducting psychosocial and lifestyle assessments (21).…”

Training for coordinating professionals as part of Dutch integrated care for childhood overweight and obesity – a mixed-methods evaluation

“…Although professionals in a variety of disciplines can ful l the role of CP, the role is often ful lled by YHC nurses in the local youth healthcare (YHC) system (16,17). The speci c competences required for the CP role have not traditionally been part of Dutch YHC nurses' education (7,12,18).…”

“…The nding relates to literature suggesting that training in obesity care can improve the con dence of HCPs (27). This might result from improved competences learned in the training, such as knowledge, skills about and appropriate attitude towards children with overweight and obesity, as it is suggested that they enhance the con dence of HCPs managing obesity (7,28,29). Since literature indicates that HCPs need to improve these competences in order to deliver adequate obesity care (7,11,(30)(31)(32), achieving such improvement is considered to be a favourable outcome of the training.…”

“…However, HCPs often feel ill-equipped to manage this complex health issue, as they believe themselves unprepared to adequately provide support and care to children with obesity (2)(3)(4). As HCPs experience their previous training to be inadequate, they favour more education to improve their knowledge, skills and attitudes for managing childhood obesity (5)(6)(7)(8)(9). It is speci cally necessary to train HCPs with behavioural skills such as motivational interviewing techniques and network care pro ciency (8).…”