Discussing childhood overweight and obesity with parents: a health communication dilemma

Mikhailovich, Katja; Morrison, Paul

doi:10.1177/1367493507082757

Cited by 65 publications

(70 citation statements)

References 37 publications

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“…However, research findings into the impact of HCP weight in weight management settings are equivocal. Some studies suggest that HCPs may give little consideration to how their own weight could affect conversations with patients (Fie, Norman, & While, 2013; Howe et al ., 2010; Mikhailovich & Morrison, 2007), whereas others indicate that HCPs are in fact conscious of the impact of their body size in interactions with patients (Brown, 2007). …”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to health care professionals discussing child weight with parents: A meta‐synthesis of qualitative studies

Bradbury

Chisholm

Watson

et al. 2018

British J Health Psychol

135

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IntroductionChildhood obesity is one of the most serious global public health challenges. However, obesity and its consequences are largely preventable. As parents play an important role in their children's weight‐related behaviours, good communication between parents and health care professionals (HCPs) is essential. This systematic review provides a meta‐synthesis of qualitative studies exploring the barriers and facilitators experienced by HCPs when discussing child weight with parents.MethodsSearches were conducted using the following databases: MEDLINE (OVID), Psych INFO (OVID), EMBASE (OVID), Web of Knowledge and CINAHL. Thirteen full‐text qualitative studies published in English language journals since 1985 were included. Included studies collected data from HCPs (e.g., nurses, doctors, dieticians, psychologists, and clinical managers) concerning their experiences of discussing child weight‐related issues with parents. An inductive thematic analysis was employed to synthesize findings.FindingsEmerging subthemes were categorized using a socio‐ecological framework into intra/interpersonal factors, organizational factors, and societal factors. Perceived barriers and facilitators most commonly related to intra/interpersonal level factors, that is, relating to staff factors, parental factors, or professional–parent interactions. HCPs also attributed a number of barriers, but not facilitators, at the organizational and societal levels.ConclusionThe findings of this review may help to inform the development of future weight‐related communication interventions. Whilst intra/interpersonal interventions may go some way to improving health care practice, it is crucial that all stakeholders consider the wider organizational and societal context in which these interactions take place. Statement of contribution What is already known on the subject? Childhood obesity is one of the United Kingdom's most serious current public health challenges.Health care professionals are in a prime position to identify child weight issues during routine consultations.However, they often feel unable or unequipped to raise the topic and provide information on child weight management. What does this study add? To our knowledge, this is the first review to synthesize barriers and facilitators to discussing child weight.This review interprets key barriers and facilitators in the context of the socio‐ecological model.Supports the development of interventions matched to the appropriate level of the socio‐economic model.

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Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to health care professionals discussing child weight with parents: A meta‐synthesis of qualitative studies

Bradbury

Chisholm

Watson

et al. 2018

British J Health Psychol

135

View full text Add to dashboard Cite

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“…[16][17][18][19][20][21][22][23] Although parents report that the physician's office is the best place to seek treatment for their child's weight, 24,25 some parents also report feeling blamed by providers for their children's excess weight and being provided with vague advice or unhelpful suggestions. 26,27 Given providers' attitudes toward patients with obesity, challenges reported by providers in discussing weight, and vulnerabilities of youth with obesity to stigma, it is critical to identify strategies to improve provider-patient discussions about overweight and obesity in youth, and to ensure that these discussions are positive, productive, and free of bias. An important first step in these efforts is to identify appropriate and nonstigmatizing language that providers can use in conversations about weight with youth with obesity and their families.…”

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confidence: 99%

Parental Perceptions of Weight Terminology That Providers Use With Youth

2011

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OBJECTIVES: Little research has been performed to examine patient perceptions of weight-related language, especially related to childhood obesity. In this study we assessed parental perceptions of weight-based terminology used by health care providers to describe a child's excess weight and assessed perceived connotations associated with these terms including stigma, blame, and motivation to reduce weight. METHODS: A national sample of American parents with children aged 2 to 18 years (N = 445) completed an online survey to assess their perceptions of 10 common terms to describe excess body weight in youth (including “extremely obese,” “high BMI,” “weight problem,” “unhealthy weight,” “weight,” “heavy,” “obese,” “overweight,” “chubby,” and “fat”). Parents were asked to use a 5-point rating scale to indicate how much they perceived each term to be desirable, stigmatizing, blaming, or motivating to lose weight. RESULTS: Regression models revealed that the terms “weight” and “unhealthy weight” were rated as most desirable, and “unhealthy weight” and “weight problem” were rated as the most motivating to lose weight. The terms “fat,” “obese,” and “extremely obese” were rated as the most undesirable, stigmatizing, blaming, and least motivating. Parents' ratings were consistent across sociodemographic variables, body weight, and child's body weight. CONCLUSIONS: The results of this study have important implications for the improvement of health care for youth with obesity; it may be advantageous for health care providers to use or avoid using specific weight-based language during discussions about body weight with families. Pediatricians play a key role in obesity prevention and treatment, but their efforts may be undermined by stigmatizing or offensive language that can hinder important discussions about children's health.

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“…Health professionals discussing weight issues with patients can be similar to "breaking bad news" [7], as they are unaware how the patient will respond to the fact that that are overweight or obese, and then to provide appropriate support and guidance, as required. Problems have been reported in communicating between health professionals and patients and also parents such as misunderstanding, define roles and responsibilities, emotion, lack of parent and patient motivation, lack of support services or resources, which are barriers for health professionals' involvement in obesity communication [21,[24][25][26][27]. Thus, the focus should be on the importance of communicating scientific knowledge to the stakeholders with a responsibility for addressing obesity including barriers [10].…”

Section: Introductionmentioning

confidence: 99%

“…Literature has clearly indicated that there is the need for high quality communication about obesity between health professionals and patients [4, [18][19][20][21][22]. However, there is limited research on the communication methods, barriers and needs among a general patient populationfrom primary care and community-based health professionals.…”

Section: Introductionmentioning

confidence: 99%

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Obesity communication among patients by health professionals: Findings from the Weight Care Project

Moorhead¹,

Coates²,

Gallagher³

et al. 2013

Health

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Obesity is on the increase worldwide and is a major global public health problem. In an increasingly obesogenic environment, it's important that health professionals are equipped to identify and address obesity issues within their clinical practice. As part of the Weight Care Project, the aim of this study was to explore the obesity-related communication issues for primary care and community-based health professionals. The study design was a quantitative survey, which was completed by 382 primary care and community-based health professionals across Northern Ireland and Republic of Ireland working with adults and children. Key findings included that the majority of the health professionals (86%) recognized having a role in giving obesity advice, acknowledged that in clinical practice communication of obesity messages is both complex and challenging (81%), and reported difficulty in sensitively addressing obesity issues (27%). The health professionals surveyed stated that they communicate obesity messages to their patients using a range of different methods, mainly verbally to individuals, leaflets and factsheets. Numerous benefits of communicating obesity messages were reported; the main one was interacting with patients to build trust. Identified barriers to communication were: limited time in patient consultations, restricted access to appropriate information, and not sure where to access appropriate resources. Communication needed be reported by the health professionals included provision of greater resources, more information on obesity management and prevention, followed by health communication training, and clear and consistent messages. Significant differences were observed, including significantly much younger health professionals considered their role to provide obesity advice (P = 0.025). It is clear from this study that health professionals view as important the need to be given information on "what" and "how" to communicate with their patients on obesity. This study highlights that health professionals need continued support to enable them to effectively address weight-related issues in a sensitive manner that is acceptable to the patient.

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Discussing childhood overweight and obesity with parents: a health communication dilemma

Cited by 65 publications

References 37 publications

Barriers and facilitators to health care professionals discussing child weight with parents: A meta‐synthesis of qualitative studies

Barriers and facilitators to health care professionals discussing child weight with parents: A meta‐synthesis of qualitative studies

Parental Perceptions of Weight Terminology That Providers Use With Youth

Obesity communication among patients by health professionals: Findings from the Weight Care Project

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