A comparison of early childhood obesity prevention in Australian general practice and child and family health settings: A mixed methods study.

Abstract

Objectives: We aimed to 1) understand and compare the knowledge, self-efficacy, practices, and attitudes of primary health professionals (PHPs) in general practice and child and family health settings regarding early childhood health promotion and obesity prevention, and 2) describe barriers and facilitators to embedding preventive care in these settings.

Methods: From August 2022 to July 2023, PHPs were recruited to participate in a mixed methods study, 227 PHPs completed a 20-item online survey and 28 participated in semi-structured interviews. Most were female, and almost half were Child and Family Health Nurses. Quantitative data were analysed descriptively, using Chi-squared or Fisher's exact tests to compare responses of Child and Family Health Nurses and PHPs in general practice. Reflexive thematic analysis of qualitative data was conducted.

Results: Child and Family Health Nurses engaged in health promotion activities (including growth assessment, and discussions of infant feeding and childhood nutrition) more frequently and were more confident doing so than general practice professionals. The latter also agreed with more statements inconsistent with current health promotion recommendations and were less likely to report having sufficient time to discuss healthy lifestyle behaviours with families. At interview professionals considered health promotion and obesity prevention an important component of their role. Organisational barriers, including limited time and staffing challenges, limit opportunities for engagement in early childhood obesity prevention.

Conclusions: PHPs require support to implement preventive care guidelines in routine practice. Professional education accompanied by organisational changes are required to support implementation of obesity prevention strategies in primary healthcare.

Implications to practice: There are many barriers to the implementation of early childhood obesity prevention in Australian primary healthcare. PHPs require training and resourcing to increase capacity to embed early childhood obesity prevention in their routine care.