Assessment and management of weight in young children

Project Status
Current

Chief Investigators
Elizabeth Denney Wilson

Project Coordinator
Mark Harris

Project Rationale

Overweight and obesity account for 7% of the burden of disease as a risk factor for long term conditions.  In 2010, 18.7 % of Kindergarten children (mean age 5.3yrs) were overweight or obese; an average annual increase of approximately 0.3% since 2004. This finding was similar to the 2007 national survey of 4-5 year children.  Early intervention is clearly needed to prevent children starting school already overweight.  A recent systematic review found that parents are both receptive to and capable of behaviour change to promote healthy weight in their young children.  Previous systematic reviews have highlighted the key role parents play in developing and maintaining healthy weight among children, mediated by behaviours that can be adopted by the whole family. Other studies suggest that primary care practitioners can assist parents by providing information on healthy eating, behaviour modification, physical activity and parenting skills

Most GPs acknowledge the importance of child obesity and their role in managing obese children yet measuring height and weight and calculating body mass index (BMI)-a simple means of estimating body fatness- is not part of routine practice. GPs who do not weigh and measure children may fail to recognise overweight children, as visual cues are insufficient to diagnose excess weight.   Primary care providers have acknowledged that they would welcome additional training, particularly in motivational interviewing to assist families of obese children. Parents agree that they expect their primary care provider to discuss their child’s weight and feeding/activity patterns.  Strategies to incorporate routine weight, height and calculation of BMI are the first step in providing early intervention. 

School aged children, and their families are regular users of primary health care (PHC) services and are ideally placed to identify children at risk of overweight and obesity, deliver brief interventions to promote healthy eating and activity and refer to community based or specialist services.  However, children are not routinely weighed and measured in primary care and so excess weight is often undetected.  Even if a child is overweight, practitioners may be reluctant to raise the issue for fear of offending or because of a perceived lack of skills in managing overweight children or lack of referral options.  There is strong evidence that brief training workshops can be effective in changing practitioner behaviour-encouraging measurement of children and brief interventions.  

Project Aim/s

To develop and evaluate educational modules and quality improvement activities for general practice on the management of child weight.

Project Design and Method

1. Development and testing of the modules in consultation with a wide range of stakeholders including government, front line health care  providers and consumers.

2. Dissemination and promotion through professional organisations and primary health networks.

3. Evaluation using mixed methods.

Publications

Nil yet