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 service managers (HSM) views is are imperative for informing the nature of future services to treat children with obesity.
This concurrent mixed-methods study, utilised questionnaires and semi-structured focus groups with clinicians, and one-on-one semi-structured interviews with HSMs, from five local health districts and one network from New South Wales. 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 analysed using descriptive statistics.
Clinicians (n=27) more often provided general healthy eating advice over a specific diet approach. Almost half of clinicians reported providing advice on intuitive/mindful eating, a quarter reported using a non-diet approach, and 80% used behaviour modification techniques. Four-fifths used body mass index percentile change as a measure of success, as well as behavioural outcomes such as improvements in physical activity levels, screen time and sleep quality. Clinicians and HSMs (n=9) reported several strengths of current services, including a multi-disciplinary, whole-of-family approach, with group education. Clinician reported barriers to service delivery including lack of transport and inflexible clinic times, while clinicians and HSMs reported barriers of poor attendance and lack of funding/resources. The most commonly endorsed future model of care featured multi-disciplinary family-based clinics, run in the community, with links to primary care. They also highlighted the need for embedded research to inform clinical practice.
Addressing common barriers to current paediatric 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.