Acceptability of Hospital-Based Pediatric Weight Management Services among Patients and Families: A Narrative Synthesis

2020 ◽  
Vol 16 (2) ◽  
pp. 129-140
Author(s):  
Caitlin M. McMaster ◽  
Megan L. Gow ◽  
Renee Neal ◽  
Shirley Alexander ◽  
Louise A. Baur ◽  
...  
2021 ◽  
pp. 136749352110521
Author(s):  
Jennifer Cohen ◽  
Shirley Alexander ◽  
Christina Signorelli ◽  
Kathryn Williams ◽  
Kyra A Sim ◽  
...  

Clinician and healthcare managers' (HCMs) views on weight management service delivery are imperative for informing the nature of future services to treat children with obesity. This qualitative study used semi-structured focus groups and one-on-one semi-structured interviews. Participants were 27 clinicians (medical, nursing, or allied health) and nine HCMs (senior executives in the hospital) who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. Clinicians reported that using a combination of group and individual sessions improved engagement with families and reduced attrition rates. Clinicians and HCMs recommended integrating clinics into community centers and providing specific programs for sub-groups, such as children from culturally and linguistically diverse communities or children with developmental delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. To improve the likelihood of future funding for pediatric weight management clinics and to optimize models of care, centers must embed research into their practice. Addressing common barriers to current pediatric weight management services and designing future models of care based on key stakeholders’ preferences is critical to achieving optimal care provision for this high-risk population.


2019 ◽  
Author(s):  
Jennifer Cohen ◽  
Shirley Alexander ◽  
Christina Signorelli ◽  
Kathryn Williams ◽  
Kyra A Sim ◽  
...  

Abstract Introduction For children with moderate to severe obesity, secondary and tertiary level services provide a platform for a more intensive approach toward weight management. Clinician and health care managers’ (HCM) views are imperative for informing the nature of future services to treat such children. Methods This concurrent mixed-methods study utilized questionnaires and semi-structured focus groups with clinicians, and one-on-one semi-structured interviews with HCMs, who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. The Theoretical Domains Framework was employed to underpin the development of the interview guides. The recorded interviews were transcribed verbatim and coded line-by-line, noting the key emerging themes. The results from the questionnaire were analyzed using descriptive statistics. Results Clinicians (n=27) provided multiple approaches to weight management, tailored to families and patients. Clinicians more often provided general healthy eating advice over a specific diet approach. Four-fifths used body mass index percentile change as a measure of success, as well as behavioral outcomes such as improvements in physical activity levels, screen time and sleep quality. Use of a combination of group and individual sessions were thought to improve engagement and reduce attrition rates. Clinicians and HCMs recommended integrating clinics into community centres and providing specific programs for sub-groups such as children from culturally and linguistically diverse communities or children with development delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. Research into clinical outcomes for services was recommended to enable the development of a business case for further funding of pediatric weight management services. Conclusion Addressing common barriers to current pediatric weight management services, and designing future models of care based on key stakeholders’ preferences, are critical to achieving optimal care provision for this high risk population.


Author(s):  
Diane C. Berry ◽  
Erinn T. Rhodes ◽  
Sarah Hampl ◽  
Caroline Blackwell Young ◽  
Gail Cohen ◽  
...  

Author(s):  
Caitlin M McMaster ◽  
Elizabeth Calleja ◽  
Jennifer Cohen ◽  
Shirley Alexander ◽  
Elizabeth Denney‐Wilson ◽  
...  

2021 ◽  
pp. 136749352110375
Author(s):  
Zina C Mc Sweeney ◽  
Morgan D McSweeney ◽  
Shirley H Huang ◽  
Samareh G Hill

Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital–based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.


2018 ◽  
Vol 9 (1) ◽  
pp. e12288 ◽  
Author(s):  
R. S. Doshi ◽  
K. A. Gudzune ◽  
L. N. Dyrbye ◽  
J. F. Dovidio ◽  
S. E. Burke ◽  
...  

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