Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

A comparison of early childhood obesity prevention in Australia between general practice and child and family health nursing services: a mixed methods study (#237)

Eve T House 1 2 3 4 , Erin Kerr 3 4 , Elizabeth Denney-Wilson 2 4 5 , Sarah Taki 1 2 3 4 , Sharlene Vlahos 6 , Alexandra Fili 6 , Karen Willcocks 6 , Kylie Hodge 6 , Chris Rossiter 5 , Heilok Cheng 2 4 5 , Louise A Baur 1 2 7 , Li Ming Wen 1 2 3 4
  1. Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
  2. NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood, (EPOCH-Translate CRE), Sydney, New South Wales, Australia
  3. Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, NSW Health, Sydney, New South Wales, Australia
  4. Sydney Institute for Women, Children and Their Families, Sydney Local Health District, NSW Health, Sydney, New South Wales, Australia
  5. Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
  6. Karitane, PO Box 241, Villawood, New South Wales, Australia
  7. Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia

Introduction: Australian primary health professionals (PHPs) have frequent contact with young children in the first 2,000 days and may support early childhood obesity prevention. This study aimed to 1) compare the knowledge, self-efficacy, practices, and attitudes towards obesity prevention in early childhood of PHPs in general practice (general practitioners and general practice nurses) and child and family health nurses (CFHNs) and 2) describe barriers and facilitators to embedding early childhood obesity prevention in these settings.

Methods: Australian PHPs caring for children aged 0-5 years were recruited from August 2022 to July 2023. PHPs completed a 20-item online survey and a smaller group participated in semi-structured interviews. Survey responses were analysed descriptively, with Chi-squared tests used to compare experiences of PHPs in general practice to CFHNs. Qualitative data were analysed thematically.

Results: 227 PHPs participated in the survey (95% female, 49% from NSW, and 56% CFHNs) and 28 in interviews (96% female, 54% from NSW, and 46% CFHNs). PHPs frequently measured and plotted infants’ growth (87% did so >50% of the time), however, fewer used growth charts to identify infants (67%) and children (51%) at risk of overweight/obesity. Compared to PHPs in general practice, more CFHNs were confident using growth charts to identify infants and children at risk of overweight or obesity (p<0.001). During interviews, PHPs in both settings described challenges discussing children’s growth with parents. Some CFHNs expressed concern regarding the focus on weight and BMI in clinical practice. PHPs in general practice identified a perceived lack of parental concern about children’s weight as a more salient challenge.

Conclusion: PHPs require more training and organisational support to embed early childhood obesity prevention in care. PHPs should be encouraged to conduct appropriate growth assessments and use a strengths-based approach, framing discussions around health behaviours and health outcomes, not body size.