Nurse Documentation of Child Weight-Related Health Promotion at Age Four in Sweden

(1) Background: Overweight and obesity in children have increased worldwide and tend to persist into adolescence and adulthood. The Child Health Service (CHS) has an important role in providing health-promotive interventions, and such interventions are required to be documented in a child’s health record. The aim of the study was to investigate Child Health Care (CHC) nurses’ documentation of weight-related, health-promotive interventions in the Child Health Care Record (CHCR) regarding lifestyle habits in connection to the four-year visit. (2) Methods: A record review of 485 CHCRs using a review template was accomplished. Of the included CHS units, four used electronic records and two used paper records. Chi-square tests and Spearman’s rank-order correlations were used to analyse data. (3) Results: The results showed that CHC nurses document interventions regarding lifestyle habits to a low extent, although children with overweight/obesity seemed to undergo more interventions. There was also a difference between electronic and paper records. (4) Conclusions: The consequences of not documenting the interventions in the CHCR make it difficult to follow up and demonstrate the quality of the CHC nurse’s work. There is a need for more research to gain a deeper understanding of the reasons that the work of CHC nurses is not visible in children’s health records.

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Adapting a parental support app for preschooler’s health behaviors (MINISTOP) in a multi-ethnic setting: A qualitative study on needs and preferences of Somali, Arabic and Swedish speaking parents and nurses within Swedish child health care (Preprint)

10.2196/preprints.26585 ◽

2020 ◽

Author(s):

Christina Alexandrou ◽

Ulrika Müssener ◽

Kristin Thomas ◽

Hanna Henriksson ◽

Marie Löf

Keyword(s):

Health Care ◽

Child Health ◽

Health Behaviors ◽

Parental Support ◽

Overweight And Obesity ◽

Preschool Age ◽

Healthy Diet ◽

Child Health Care ◽

Dietary Recommendations ◽

Clear Information

BACKGROUND Similar to other high-income countries, Sweden has a socioeconomic gradient of obesity, with twice as high prevalence of childhood overweight and obesity in areas were the population is predominantly immigrant and more socioeconomically vulnerable. Preventive efforts in primary child health care to counteract this development already in the preschool age has been called for. Mobile health (mHealth) represents an attractive approach to deliver such obesity interventions as they are highly flexible and adaptable. However, knowledge is limited regarding what adaptations of content and features that are required to also make such interventions accessible and effective for parents with a foreign background. OBJECTIVE This study aimed to explore: (1) needs and concerns among Somali, Arabic and Swedish speaking parents in terms of supporting healthy diet and activity behaviors in their children; (2) nurses’ perceptions of parental needs and concerns, in relation to diet and physical activity behaviors, and (3) how features and content of a parental support app (MINISTOP 1.0) could be refined to better support health behaviors in children, among both parents and nurses. METHODS Three focus group interviews with parents speaking Somali (n=5), Arabic (n=4) and Swedish (n=6), and 15 individual telephone interviews with Swedish primary child health care nurses from different geographic and socioeconomic areas in Sweden were conducted. All interviews were audio-recorded, transcribed verbatim, and analyzed using an inductive thematic approach. RESULTS Two main themes were identified in the data. The first theme, “Parenthood and health behaviors”, highlighted insecurities and concerns among parents relating to a healthy diet in their children. Swedish speaking parents expressed being stressed about trying to adhere to dietary recommendations, while Arabic speaking parents requested clear information on how to adhere to them. Nurses underlined the need of targeting parents early and strengthening them in their parenting role. In the second theme, “Preferences of content and features”, parents and nurses expressed key aspects that needed to be included in an app. For example, parents from all three focus groups suggested inclusion of clear and reassuring information on children’s diet and eating behaviors. Parents also requested inclusion of social and emotional support rather than just recommendations per se. Nurses talked about the value of a shared digital platform with clear information and pictures, available in different languages, to aid their communication with the parents. CONCLUSIONS This study contributes with valuable insights and knowledge about adapting a parental app supporting health behaviors in children in a multi-ethnic setting. Findings include the importance of strengthening parents in their role, as well as translating and making relevant adaptations to the app, for it to be accessible for parents speaking other languages and facilitate parent-nurse communication.

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MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study

BMC Public Health ◽

10.1186/s12889-020-09808-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hanna Henriksson ◽

Christina Alexandrou ◽

Pontus Henriksson ◽

Maria Henström ◽

Marcus Bendtsen ◽

...

Keyword(s):

Physical Activity ◽

Health Care ◽

Childhood Obesity ◽

Child Health ◽

Overweight And Obesity ◽

Control Group ◽

Child Health Care ◽

Major Health Problem ◽

Diet And Physical Activity ◽

Preschool Aged Children

Abstract Background Childhood obesity is still a major health problem in many countries, including Sweden. Childhood obesity and obesity-related behaviours in childhood, such as low physical activity and unhealthy eating habits, tend to track into adulthood, which highlights the need for early prevention. Our aims are to evaluate whether a parent-oriented mobile health app (the MINISTOP 2.0 app) integrated into primary child health care can improve diet and physical activity behaviours and reduce the prevalence of overweight and obesity in preschool-aged children as well as to evaluate the implementation among child health care nurses and parents. Methods This trial uses a hybrid type 1 effectiveness-implementation design. Families (n = 500) who attend a routine visit to one of 15–20 primary child health care centres throughout Sweden, when their child is 2.5 years, are offered participation in a randomised controlled trial (effectiveness evaluation). After acceptance, families will be randomised (1:1) to control or intervention groups. The intervention group receives a 6-month parent-oriented smartphone intervention aimed at improving the dietary and activity behaviours of their child (the MINISTOP 2.0 app) and the control group receives routine child health care. Dietary habits, physical activity and screen time (primary outcomes), body weight and height in children, and parental self-efficacy (secondary outcomes) are measured at baseline and at 6 months post randomisation. Implementation outcomes (i.e. perceived acceptability, appropriateness, and feasibility) of the intervention will be assessed among primary child health care nurses and parents in the trial through questionnaires and qualitative interviews. Discussion This trial will evaluate whether the MINISTOP 2.0 app can be used in primary child health care to improve diet and physical activity behaviours, and prevent overweight and obesity, in preschool-aged children. If effectiveness is proven, and the MINISTOP 2.0 app is considered acceptable, appropriate and feasible, it can be implemented nationally as part of the preventive strategies to combat childhood obesity provided by routine child health care. Trial registration The trial was registered at the Clinicaltrials.gov register platform (ID NCT04147039) on 31 October 2019.

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Planting a seed - child health care nurses’ perceptions of speaking to parents about overweight and obesity: a qualitative study within the STOP project

BMC Public Health ◽

10.1186/s12889-019-7852-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

My Sjunnestrand ◽

Karin Nordin ◽

Karin Eli ◽

Paulina Nowicka ◽

Anna Ek

Keyword(s):

Health Care ◽

Childhood Obesity ◽

Child Health ◽

Communication Skills ◽

Organizational Factors ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Child Health Care ◽

Stockholm County ◽

Nurses Perceptions

Abstract Background Nurses in child health care (CHC) centers in Sweden play a key role in the early detection and management of childhood overweight/obesity, through meeting families early, regularly and over many years. However, research focusing on CHC nurses’ perceptions of their role in childhood overweight/obesity management is scarce. As part of the EU-funded project “Science and Technology in childhood Obesity Policy” (STOP), this study examines CHC nurses’ perceptions of speaking to parents about children’s overweight/obesity and of their role in referring children to treatment for overweight/obesity. Methods All registered CHC nurses in Stockholm County (n = 442) received an email invitation letter explaining the study. Individual face-to-face visits (n = 15) in selected centers, and phone calls (n = 24) to nurses working in these centres were also conducted. In total, 17 CHC nurses (all female, average work experience 6.7 years (SD ± 4.9 years)) from 10 municipalities (including four of the top five municipalities with the highest prevalence of overweight and obesity) in Stockholm County were interviewed. The interviews were conducted by phone, transcribed and analyzed using thematic analysis. Results Two main themes were developed through the analysis: 1) The relationship between the nurse and the parent and 2) Glitch in the system. Under the first theme, nurses reported that weight-related discussions were facilitated by building and maintaining trust with parents. However, nurses also said they were reluctant to address children’s weights if this could compromise parents’ trust. Under the second theme, nurses highlighted several organizational barriers to addressing a child’s weight with parents, including insufficient cooperation with other healthcare providers and limited time for visits. Nurses also identified lack of sufficient knowledge about what to offer the family and lack of confidence in their communication skills as additional barriers. Conclusions We found that pediatric nurses perceive relational and organizational factors as barriers to address childhood obesity with parents. To improve care, it is necessary to provide nurses with continuing education about obesity and communication skills and organizational support to improve communication within the healthcare system. Trial registration ClinicalTrials.gov NCT03800823; 11 Jan 2019, prospectively registered.

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Obstacles to the prevention of overweight and obesity in the context of child health care in Sweden

BMC Family Practice ◽

10.1186/1471-2296-14-143 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 8

Author(s):

Gabriella E Isma ◽

Ann-Cathrine Bramhagen ◽

Gerd Ahlstrom ◽

Margareta Östman ◽

Anna-Karin Dykes

Keyword(s):

Health Care ◽

Child Health ◽

Overweight And Obesity ◽

Child Health Care

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Improving Maternal and Child Health Care: A Blueprint for Community Action in Pittsburgh Region: Summary

PsycEXTRA Dataset ◽

10.1037/e563542010-001 ◽

2005 ◽

Author(s):

Harold Alan Pincus ◽

Stephen B. Thomas ◽

Donna J. Keyser ◽

Nicholas Castle ◽

Jacob W. Dembosky ◽

...

Keyword(s):

Health Care ◽

Child Health ◽

Maternal And Child Health ◽

Community Action ◽

Child Health Care ◽

And Child Health

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Leveraging child health care to promote responsive parenting and school readiness: 24- and 36-month findings from the video interaction project

PsycEXTRA Dataset ◽

10.1037/e584752012-235 ◽

2010 ◽

Author(s):

Alan Mendelsohn ◽

Samantha Berkule-Silberman ◽

Lesley Morrow ◽

Catherine S. Tamis-LeMonda ◽

Carolyn Brockmeyer ◽

...

Keyword(s):

Health Care ◽

Child Health ◽

School Readiness ◽

Child Health Care ◽

Responsive Parenting

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Health Cadres Commitmentin Child Health Care in Moslem Society of Banyumas District

International Conference of Moslem Society ◽

10.24090/icms.2016.2382 ◽

2016 ◽

Vol 1 ◽

pp. 60-65

Author(s):

Umi Solikhah ◽

Hari Kusnanto ◽

Fitri Haryanti

Keyword(s):

Health Care ◽

Child Health ◽

Health Services ◽

Group Discussion ◽

Community Empowerment ◽

Child Health Services ◽

Child Health Care ◽

Minimum Requirements ◽

Social Esteem ◽

The Government

Community empowerment with regard to maternal and child health services at the community level carried out by cadre.Cadre is health volunteers, selected by the community.404 number of active cadres in primary health care of South Purwokerto entirely female, although it may be a cadre of men. Active cadre toddler actively providing services every month for child before 5 years age. Interest to know the various reasons committed cadres in performing their duties. The method used is qualitative study,to describe a variety of reasons commitment to perform cadre duties in child health care. Retrieving data using interview techniques through the focus group discussion. Data from 30 cadres.Results of interviews taken until the data saturation, as a reason believed by cadres in the commitment to carry out tasks of serving the Muslim community. Characteristic respondent are mean of age 38 years (the youngest age of 25 years and the oldest 55 years old), a 100% Islamic religion, level of education majority of senior high school(at least primary school). Educational level health cadres in Banyumas has met the minimum requirements by the WHO.Results of the analysis showed thatcommitment includes a cadre of dedicated, caring community, a desire to learn, social esteem, individual satisfaction, togetherness, organization, and spirituality. The spirit of cadre to the community need the attention of the government for development and prosperity in accordance with their duties.Spiritual reasons become one of the motivations in providing health services to the community, albeit to a spirit of dedication and a great desire to learn. Cadres continue to provide services, even to families with different spiritual.

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