Conversation cards help families with pediatric weight management issues

Conversation cards (CCs), a priority-setting tool in pediatric weight management, may be useful in describing family priorities, according to a recent study published in the Journal of Nutrition Education and Behavior.

Because the number of children and adolescents who struggle with obesity is increasing, and health care providers may be challenged in effectively counseling families on weight management, CCs were developed to aid these families in considering and prioritizing their challenges in the weight management of their children.

Researchers conducted a retrospective medical record review in 146 children age 2 to 17 years, who were obese, and their families who were enrolled in a pediatric weight management clinic between January 2012 and September 2016.

During a monthly, group-based orientation session, these families were given an introduction to CCs, and then referred for care by local physicians and nurse practitioners.

On average, families selected 10 CCs, equally divided between positive statements, such as “Ongoing contact with our clinician keeps us motivated,” and negative statements such as “I feel overwhelmed and lack support.”

The most common card choices reflected the families’ readiness to make healthy changes, their preference for involving children/adolescents in clinical discussions, the importance of children/adolescents sharing their thoughts, learning how to make healthy foods fun, and a desire for a specially trained fitness instructor to work with children and adolescents.

“The needs and preferences of families relating to motivation and clinical support, especially across socioeconomic groups, revealed the complexity of patient- and family-level priorities that providers can address,” said lead author Maryam Kebbe, BSc, department of pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Kebbe and fellow researchers found that only 50% of families had a perceived readiness to make healthy changes. Less healthy eating behaviors were found in adolescents compared with children (P=0.0010) and less healthy physical activity habits as well (P=0.002). Across several sociodemographic characteristics, goal setting was perceived as a motivator (all P < 0.05).

They also found that age affected attitudes, with a greater number of adolescents disliking exercise and bought fast food when their parents were not present, compared with younger children. Socioeconomic status also affected attitudes, with a greater proportion of parents with a higher level of education and lower household income reporting that setting goals helped them remain motivated. In families with lower income, limited finances limited what they could do. Finally, a greater proportion of parents with a lower education levels also had financial limitations that affected their ability to register their children in sports.

“Offering families services that align with their readiness, motivation, and ability to participate actively in pediatric weight management is ideal. CCs may be useful to complement existing processes and procedures for both providers and families,” concluded Kebbe.

Further research on the effects of using CCs is underway, including a study to determine whether CCs can help families in goal setting and enhancing motivation to change habits over time.

For a podcast interview with Maryam Kebbe, BSc, department of pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada, please go to: http://www.jneb.org/pb/assets/raw/Health%20Advance/journals/jneb/49_7_JNEB_PR_Ball_Kebbe_podcast.mp3