Abstract
Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. To explore barriers and facilitators to using the 3D BSS through a mixed-methods design. For the qualitative phase, parents of toddlers (n = 38) participated in semi-structured interviews introducing the 3D BSS of 4-5-year-old children. For the quantitative phase, pre- and post-interview questionnaires were administered to ascertain the acceptability of the 3D BSS. Parents rated the 3D BSS as "very" (n = 20, 52.6%) to "moderately" (n = 12, 31.6%) acceptable. Thematic analysis revealed four barriers to acceptability: i) the sensitive nature of child weight, ii) the belief that weight does not determine health, iii) the visual normalisation of overweight and iv) the need to account for individual variation in growth patterns. However, these barriers could be overcome through three facilitators: i) the provision of expert guidance ii) the value of simple tools, and iii) tailoring conversations to familial needs. Parents considered the 3D BSS an acceptable visual resource to discuss child weight during routine appointments. However, the acceptability of the tool was conditional on a sensitive, collaborative, and tailored delivery approach.
Highlights
The 3D 3D Body Size Scale (BSS) of 4–5year-olds was sent to parents alongside the National Child Measurement Programme (NCMP) feedback letter and was shown to double the uptake of a child-weight-management service.[16]
These findings suggest that applying a similar 3D body size scale (3D BSS) for toddlers into routine pediatric conversations may aid understanding of weight development and thereby increase engagement with beneficial health behaviours
For the full interview schedule see Figure S2. This design enabled exploration of how parental responses may vary by two manipulated factors, (a) the weight status of the toddler in the vignette and (b) the order in which visual tools were presented by the Health Visitor (UK-WHO growth chart for girls 0–4 vs. 3D BSS)
Summary
Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. Thematic analysis revealed four barriers to acceptability: i) the sensitive nature of child weight, ii) the belief that weight does not determine health, iii) the visual normalisation of overweight and iv) the need to account for individual variation in growth patterns. These barriers could be overcome through three facilitators: i) the provision of expert guidance ii) the value of simple tools, and iii) tailoring conversations to familial needs. KEYWORDS child growth, health care professionals, mixed-methods, pediatric obesity, pre-schoolers, visual tools, weight conversations
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