Preventing childhood obesity during infancy in UK primary care: a mixed-methods study of HCPs' knowledge, beliefs and practice

BMC Family Practice

Research Article

Philippa J Atkinson¹  Dilip Nathan²  Judy A Swift³  Cris Glazebrook⁴  Aloysius N Siriwardena⁵  Sarah A Redsell⁶ 

[1] Nottingham City Care Partnership, 1 Standard Court, NG1 6GN, Nottingham, UK;Nottingham University Hospitals NHS Trust, NG7 2UH, Nottingham, UK;School of Bioscience, The University of Nottingham, Sutton Bonington Campus, LE12 5RD, Loughborough, UK;School of Community Health Sciences, The University of Nottingham, NG7 2HA, Nottingham, UK;School of Health and Social Care, University of Lincoln, LN6 7TS, Lincoln, UK;School of Nursing, Midwifery and Physiotherapy, The University of Nottingham, Queen's Medical Centre, B Floor, South Block, NG7 2HA, Nottingham, UK;

关键词: Obesity;    Childhood Obesity;    Practice Nurse;    Obesity Prevention;    Infant Feeding;   

DOI  :  10.1186/1471-2296-12-54

 received in 2011-03-09, accepted in 2011-06-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThere is a strong rationale for intervening in early childhood to prevent obesity. Over a quarter of infants gain weight more rapidly than desirable during the first six months of life putting them at greater risk of obesity in childhood. However, little is known about UK healthcare professionals' (HCPs) approach to primary prevention. This study explored obesity-related knowledge of UK HCPs and the beliefs and current practice of general practitioners (GPs) and practice nurses in relation to identifying infants at risk of developing childhood obesity.MethodSurvey of UK HCPs (GPs, practice nurses, health visitors, nursery, community and children's nurses). HCPs (n = 116) rated their confidence in providing infant feeding advice and completed the Obesity Risk Knowledge Scale (ORK-10).Semi-structured interviews with a sub-set of 12 GPs and 6 practice nurses were audio recorded, taped and transcribed verbatim. Thematic analysis was applied using an interpretative, inductive approach.ResultsGPs were less confident about giving advice about infant feeding than health visitors (p = 0.001) and nursery nurses (p = 0.009) but more knowledgeable about the health risks of obesity (p < 0.001) than nurses (p = 0.009). HCPs who were consulted more often about feeding were less knowledgeable about the risks associated with obesity (r = -0.34, n = 114, p < 0.001). There was no relationship between HCPs' ratings of confidence in their advice and their knowledge of the obesity risk.Six main themes emerged from the interviews: 1) Attribution of childhood obesity to family environment, 2) Infant feeding advice as the health visitor's role, 3) Professional reliance on anecdotal or experiential knowledge about infant feeding, 4) Difficulties with recognition of, or lack of concern for, infants "at risk" of becoming obese, 5) Prioritising relationship with parent over best practice in infant feeding and 6) Lack of shared understanding for dealing with early years' obesity.ConclusionsIntervention is needed to improve health visitors and nursery nurses' knowledge of obesity risk and GPs and practice nurses' capacity to identify and manage infants' at risk of developing childhood obesity. GPs value strategies that maintain relationships with vulnerable families and interventions to improve their advice-giving around infant feeding need to take account of this. Further research is needed to determine optimal ways of intervening with infants at risk of obesity in primary care.

【 授权许可】

CC BY   
© Redsell et al; licensee BioMed Central Ltd. 2011