Abstract
BackgroundBecause parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported.MethodsThis mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0–5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles.ResultsAlthough nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation.ConclusionWhile MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-015-0077-7) contains supplementary material, which is available to authorized users.
Highlights
Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours
Sample characteristics A total of 56 out of 66 (84.8 %) MCH nurses across the two Local Government Areas (LGAs) completed the quantitative survey, with 16 interviews completed from the 20 who initially expressed an interest in participating in an interview
Obesity prevention practices (Table 2) Growth monitoring and identifying ‘at risk’ infants/children measurement of height/length and weight was commonplace, a significant portion of nurses (22.2 %) rarely used growth charts to identify infants or children at risk of overweight or obesity (Table 2). This is despite virtually all nurses reporting having easy access to standard growth charts (Table 3) and the majority being confident in using these charts to identify those at risk of overweight or obesity (Table 2)
Summary
Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. Children’s weight status, food intakes and food preferences track over time [10, 11] and parents play a primary role in shaping these behaviours through different feeding styles and the food and physical activity environments they provide [12]. Together these findings suggest that early childhood is a critical time in which many risk factors for overweight and obesity emerge, and when habits are formed, providing an opportunity for establishing and promoting behaviours that will affect weight gain and health across the life course
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